Cardiovascular Toxicity and Risk Mitigation with Lung Cancer Treatment

Treatment‐related cardiovascular events in patients with non–small cell lung cancer: Evidence from real‐world data with a competing risks approach

“…Notably, our study might not have captured the full extent of radiotherapy‐related CV events, particularly events that occurred after 2 years of treatment. Previous studies have reported that radiotherapy‐associated CV events can occur over a wide time frame, which ranges from months to years, even decades 21,22 . Assessing long‐term radiotherapy‐associated CV events was left for future study.…”

“…Given the significantly elevated risk of CV events in patients with lung cancer, which could affect survival and survivorship care, it is crucial that strategies should be developed for risk mitigation. The findings of recent studies suggest that strategies for monitoring high‐risk groups and related interventions should focus on three areas: risk factor control, risk‐reducing medications, and monitoring symptoms 22 . More specifically, it is suggested that patients, especially elderly patients with lung cancer, should be assessed and controlled for common risk factors such as smoking, hypertension, and poor performance status.…”

“…A previous study suggested that for patients with lung cancer undergoing surgery who have elevated perioperative N‐terminal pro–brain natriuretic peptide levels, postoperative administration of metoprolol or losartan may be considered to reduce the risk of atrial fibrillation 50 . In addition, to appropriately manage CV events, it was recommended that particular attention be paid to monitoring heart rate and CV symptoms during and after chemotherapy and/or radiotherapy to allow for early detection of these events 22 …”

“…CV events have been extensively studied in patients with breast cancer with real‐world or cohort data; however, only a few studies have evaluated CV events in patients with lung cancer, who are usually exposed to diverse treatments and in whom the occurrence of CV events might delay treatment and affect overall survival 18 . Recent studies on lung cancer are mostly review studies or studies focused on a specific treatment; there is limited comprehensive evidence with detailed treatment information on this subject in actual practice 5,6,19–25 . For example, two previous studies evaluated the risk of atrial fibrillation in surgically treated patients with cancer, and a recent study evaluated CV events among patients with stage III NSCLC treated with chemoradiation or chemotherapy only 23–25 .…”

“…18 Recent studies on lung cancer are mostly review studies or studies focused on a specific treatment; there is limited comprehensive evidence with detailed treatment information on this subject in actual practice. 5,6,[19][20][21][22][23][24][25] For example, two previous studies evaluated the risk of atrial fibrillation in surgically treated patients with cancer, and a recent study evaluated CV events among patients with stage III NSCLC treated with chemoradiation or chemotherapy only. [23][24][25] It is necessary to evaluate the incidence of CV events in patients with lung cancer during treatment with evidence from clinical practice, including real-world data (RWD), particularly data from electronic health records (EHRs), to provide comprehensive insights into CV events and aid decision-making for the management of patients with cancer.…”