Vascular Inflammation and Cardiovascular Burden in Metastatic Breast Cancer Female Patients Receiving Hormonal Treatment and CDK 4/6 Inhibitors or Everolimus

Papageorgiou, Christos; Zagouri, Flora; Tampakis, Konstantinos; Georgakopoulou, Rebecca; Kafouris, Pavlos; Benetos, Georgios; Koutagiar, Iosif; Anagnostopoulos, Constantinos; Dimopoulos, Meletios A.; Toutouzas, Konstantinos

doi:10.3389/fcvm.2021.638895

Cited by 12 publications

(13 citation statements)

References 34 publications

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“…A cohort of 22 female patients diagnosed with metastatic breast cancer, who were administered CDK4/6 inhibitors or everolimus along with standard hormonal treatment, were studied by a research team to examine the cardiovascular burden and vascular inflammation over a period of 6 months. 108 The present investigation revealed that the administration of CDK 4/6 inhibitors and hormonal therapy induces vascular inflammation, hypertensive response, and left ventricle remodeling. Unlike these studies, one study observed no cardiac adverse effects of palbociclib.…”

Section: Cardiotoxicity Of Oncologic Therapiesmentioning

confidence: 56%

Section: Future Directionsmentioning

confidence: 99%

“…Research on CDK4/6 inhibitors and their potential cardiotoxicity is an important area of study, as these drugs have shown promise in cancer treatment but may have cardiotoxic effects. 105,106,[108][109][110][111][112][113][114][115][116][117][118][119][120][121][122] Some future research directions could include: Interdisciplinary collaboration between oncologists, cardiologists, pharmacologists, and researchers in various related fields will be crucial for advancing our understanding of CDK4/6 inhibitor cardiotoxicity and improving patient outcomes.…”

Section: Future Directionsmentioning

confidence: 99%

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CDK4/6 inhibitors: basics, pros, and major cons in breast cancer treatment with specific regard to cardiotoxicity – a narrative review

Pavlovic,

Niciforovic,

Papic

et al. 2023

Ther Adv Med Oncol

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Breast cancer is characterized by the uncontrolled proliferation of breast cells, with a high incidence reported in 2020 to have affected over 2 million women. In recent years, the conventional methods of treating breast cancer have involved radiotherapy and chemotherapy. However, the emergence of CDK4/6 inhibitors has shown potential as a promising cancer therapy. Cyclin-dependent kinases (CDK) inhibitors are a class of molecules that impede the formation of an active kinase complex, thereby hindering its activity and consequently halting the progression of the cell cycle. It was discovered that they have a significant impact on impeding the progression of the cancer. This is evident with the Food and Drug Administration’s approval of drugs such as palbociclib, ribociclib, and abemaciclib for hormone receptor-positive metastatic breast cancer in combination with specific endocrine therapies. In spite of enormous success in breast cancer treatment, certain obstacles have emerged, such as therapy resistance, side effects, and most of all, cardiotoxicity. Some of these drawbacks have been successfully overcome by dosage reduction, different combinations of the drugs, and the assessment of each patient’s condition and suitability prior to treatment. Yet other drawbacks still require tenacious research, especially certain cases of cardiotoxicities. This article delves into the biological mechanisms of CDK4/6 in the cell cycle and cancer, as well as the clinical advantages and most common adverse events (AEs) associated with CDK4/6 inhibitors. The primary objective of this review is to provide a comprehensive analysis of cardiotoxic AEs and elucidate the underlying pathophysiological mechanisms responsible for the cardiotoxicity of CDK4/6 inhibitors.

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Section: Cardiotoxicity Of Oncologic Therapiesmentioning

confidence: 56%

Section: Future Directionsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

See 1 more Smart Citation

CDK4/6 inhibitors: basics, pros, and major cons in breast cancer treatment with specific regard to cardiotoxicity – a narrative review

Pavlovic,

Niciforovic,

Papic

et al. 2023

Ther Adv Med Oncol

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“…7 One report found that CDK4/6 inhibitors may increase vascular inflammation, increase hypertension, alter left ventricle geometry and that individuals on these medications should be closely monitored for adverse cardiac outcomes. 8 In vitro, abemaciclib has been found to induce apoptosis, inhibiting cell viability and proliferation of cardiomyocytes which may lead to cardiac adverse events. 9 This has yet to be demonstrated with palbociclib or ribociclib.…”

Section: Cardiomyopathymentioning

confidence: 99%

Elevated transaminases and development of cardiomyopathy in a 32-year-old woman with metastatic breast cancer after treatment with ribociclib followed by palbociclib

Watts

Nadori

2022

J Oncol Pharm Pract

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Introduction Cyclin-dependent kinase 4 and 6 inhibitors, ribociclib and palbociclib, are associated with reports of transaminitis and adverse cardiac events. Case report The patient is a previously healthy 32-year-old female diagnosed with estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor 2 negative metastatic breast cancer. From July to September 2021, the patient was initiated on ribociclib followed by palbociclib for metastatic breast cancer. She subsequently experienced two episodes of transaminitis and was diagnosed with cardiomyopathy. Management and outcome The patient experienced transaminitis 2 weeks after the initiation of ribociclib resulting in discontinuation. When rechallenged with palbociclib, the patient experienced transaminitis within 1 week of initiation, which resulted in discontinuation. Approximately 1 month after palbociclib discontinuation, the patient was diagnosed with congestive heart failure with a left ventricular ejection fraction of 24%. Discussion To our knowledge, there are few case studies investigating cyclin-dependent kinase 4 and 6 inhibitor rechallenge following transaminitis. Prior literature suggests that transaminitis with cyclin-dependent kinase 4 and 6 inhibitors is not a class effect, but this case report suggests otherwise. This report presents a rare case of cardiomyopathy and transaminitis following the administration of cyclin-dependent kinase 4 and 6 inhibitors, ribociclib and palbociclib.

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“…30,31 18 F-FDG PET/ CT imaging is also a proven strategy for detecting and quantifying serial changes in arterial inflammation in adults with cancer. [32][33][34][35] However, to date, no studies have evaluated the utility of 18 F-FDG PET/CT imaging for quantifying chemotherapy-induced venous toxicity in pediatric and AYA cancers or assessed if image-derived measures of venous inflammation predict risk of VTE events. Therefore, the present study sought to evaluate the utility of standard of care whole-body 18 F-FDG PET/ CT imaging for detecting chemotherapy-induced venous toxicity and assess its prognostic value for predicting risk for VTE in the 12 months after lymphoma diagnosis in pediatric and AYA patients.…”

mentioning

confidence: 99%

Prognostic Value of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging for Predicting Venous Thromboembolism in Children With Lymphoma

Beall

Deep

Tram

et al. 2023

Circ: Cardiovascular Imaging

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Background: Positron emission tomography (PET)/computed tomography (CT) imaging can detect changes in arterial inflammation, but has not been used to evaluate chemotherapy-induced venous inflammation or assess risk for venous thromboembolism (VTE) in pediatric oncology. Therefore, the purpose of this study was to evaluate the prognostic value of fluorine-18-fluorodeoxyglucose PET/CT imaging of venous inflammation for predicting VTE occurrence in the 12 months after lymphoma diagnosis in pediatric, adolescent, and young adult patients. Methods: Pediatric, adolescent, and young adult patients with lymphoma diagnoses (n=71) who underwent whole-body PET/CT imaging at initial staging of disease and first therapeutic follow-up were retrospectively evaluated for serial changes in lower extremity venous uptake of fluorine-18-fluorodeoxyglucose. PET/CT images were used to segment and quantify serial changes in fluorine-18-fluorodeoxyglucose uptake for veins of interest (ie, popliteal and femoral). Incidence of VTE was assessed for 12 months after lymphoma diagnosis. Results: PET/CT detected a significantly higher inflammatory response in the femoral ( P =0.012) and popliteal ( P =0.013) veins of patients who experienced a VTE event compared with those who remained VTE free in the 12 months after diagnosis. The area under the curve values for receiver operator characteristics analyses were 0.76 (femoral vein) and 0.77 (popliteal vein) based on incidence of VTE occurrence. Univariate analyses demonstrated that PET/CT-derived changes in femoral ( P =0.008) and popliteal ( P =0.002) vein inflammation were significantly associated with VTE-free survival at 12 months after diagnosis. Conclusions: Fluorine-18-fluorodeoxyglucose PET/CT imaging detects treatment-induced venous toxicity that may provide insight into risk of VTE events in pediatric and adolescent and young adult patients with lymphoma.

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Vascular Inflammation and Cardiovascular Burden in Metastatic Breast Cancer Female Patients Receiving Hormonal Treatment and CDK 4/6 Inhibitors or Everolimus

Cited by 12 publications

References 34 publications

CDK4/6 inhibitors: basics, pros, and major cons in breast cancer treatment with specific regard to cardiotoxicity – a narrative review

CDK4/6 inhibitors: basics, pros, and major cons in breast cancer treatment with specific regard to cardiotoxicity – a narrative review

Elevated transaminases and development of cardiomyopathy in a 32-year-old woman with metastatic breast cancer after treatment with ribociclib followed by palbociclib

Prognostic Value of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging for Predicting Venous Thromboembolism in Children With Lymphoma

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