Onco-Cardiology: Consensus Paper of the German Cardiac Society, the German Society for Pediatric Cardiology and Congenital Heart Defects and the German Society for Hematology and Medical Oncology

Abstract

The acute and long-lasting side effects of modern multimodal tumour therapy significantly impair quality of life and survival of patients afflicted with malignancies. The key components of this therapy include radiotherapy, conventional chemotherapy, immunotherapy and targeted therapies. In addition to established tumour therapy strategies, up to 30 new therapies are approved each year with only incompletely characterised side effects. This consensus paper discusses the risk factors that contribute to the development of a potentially adverse reaction to tumour therapy and, in addition, defines specific side effect profiles for different treatment groups. The focus is on novel therapeutics and recommendations for the surveillance and treatment of specific patient groups.

ECG Scoring for the Evaluation of Therapy-Naïve Cancer Patients to Predict Cardiotoxicity

“…Cardiotoxicity was diagnosed if the LV function decreased by ≥10% to <50% or if the global longitudinal strain (GLS) decreased by 15% according to current recommendations [ 1 , 6 ].…”

“…Baseline evaluation of cardio-oncology patients includes patient history, physical examination, cardiac biomarkers including high-sensitive Troponin I or T (hsTnI or hsTnT) and the N-terminal fragment of the pro brain natriuretic peptide (NT-proBNP), echocardiography to assess LV function and global longitudinal strain (GLS) and electrocardiographic (ECG) analysis. ECG analysis is a recommended component of each cardio-oncological evaluation, because malignant arrhythmias are frequent side effects of many cancer therapies (e.g., anthracyclines, small-molecule tyrosine kinase inhibitors, Bruton’s tyrosine kinase inhibitors, immune checkpoint inhibitors and B-Raf proto-oncogene serine/threonine-kinase (BRAF) inhibitors) [ 3 , 6 , 7 , 8 ]. Early identification of ECG abnormalities associated with structural or electrical alterations is therefore of great importance.…”

Pathomechanisms and therapeutic opportunities in radiation-induced heart disease: from bench to bedside

“…The prevention or management of radiogenic CVDs has become a challenge in clinical practice since RIHD can worsen the outcome, quality of life, and health care costs in long-term cancer survivors [ 12 , 13 ]. These factors have recently contributed to the emergence of a new specialty termed onco-cardiology or cardio-oncology.…”

“…Therefore, understanding the exact molecular mechanisms in the progression of RIHD is necessary for developing preventive and therapeutic strategies without attenuating the effect of RT on cancer cells. Tailored surveillance of patients according to their risk status serves early intervention if necessary [ 12 , 13 ].…”

Editorial: Emerging Challenges of Cardiovascular and Metabolic Dysfunctions in Cardio-Oncology: From Bench to Bedside

“…The number of cancer survivors is increasing and up to 30 new cancer therapies are approved each year with only incompletely characterized side effects (1). Many anti-cancer drugs including traditional, new targeted kinase inhibitors and immunotherapies are associated with cardiovascular and metabolic adverse effects and may have dramatic impact on morbidity and mortality (2).…”