Cardio-Oncology Service, Royal Brompton Hospital and Imperial College, London, UK.
Duke Cancer Institute, Duke University, Durham, NC, USA.
Eur J Heart Fail. 2020 Nov;22(11):1945-1960. doi: 10.1002/ejhf.1920. Epub 2020 Aug 6.
This position statement from the Heart Failure Association of the European Society of Cardiology Cardio-Oncology Study Group in collaboration with the International Cardio-Oncology Society presents practical, easy-to-use and evidence-based risk stratification tools for oncologists, haemato-oncologists and cardiologists to use in their clinical practice to risk stratify oncology patients prior to receiving cancer therapies known to cause heart failure or other serious cardiovascular toxicities. Baseline risk stratification proformas are presented for oncology patients prior to receiving the following cancer therapies: anthracycline chemotherapy, HER2-targeted therapies such as trastuzumab, vascular endothelial growth factor inhibitors, second and third generation multi-targeted kinase inhibitors for chronic myeloid leukaemia targeting BCR-ABL, multiple myeloma therapies (proteasome inhibitors and immunomodulatory drugs), RAF and MEK inhibitors or androgen deprivation therapies. Applying these risk stratification proformas will allow clinicians to stratify cancer patients into low, medium, high and very high risk of cardiovascular complications prior to starting treatment, with the aim of improving personalised approaches to minimise the risk of cardiovascular toxicity from cancer therapies.
本立场声明由欧洲心脏病学会心力衰竭协会心脏肿瘤学研究小组与国际心脏肿瘤学会合作编写,为肿瘤学家、血液肿瘤学家和心脏病学家提供了实用、易用且基于证据的风险分层工具,以便在临床实践中对接受已知可导致心力衰竭或其他严重心血管毒性的癌症治疗的肿瘤患者进行风险分层。在接受以下癌症治疗之前,为肿瘤患者提供了基线风险分层表:蒽环类化疗、曲妥珠单抗等 HER2 靶向治疗、血管内皮生长因子抑制剂、针对 BCR-ABL 的第二代和第三代多靶点激酶抑制剂、慢性髓性白血病治疗药物(蛋白酶体抑制剂和免疫调节药物)、RAF 和 MEK 抑制剂或雄激素剥夺疗法。应用这些风险分层表,将使临床医生能够在开始治疗之前将癌症患者分为心血管并发症低、中、高和极高风险组,旨在改善个性化方法,最大限度地降低癌症治疗的心血管毒性风险。