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Cardiac Toxicities in Oncology: Elucidating the Dark Box in the Era of Precision Medicine.

作者信息

Samuel Younan, Babu Aswin, Karagkouni Foteini, Ismail Ayden, Choi Sunyoung, Boussios Stergios

机构信息

Department of Cardiology, Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, Kent, UK.

GKT School of Medicine, King's College London, London SE1 9RT, UK.

出版信息

Curr Issues Mol Biol. 2023 Oct 15;45(10):8337-8358. doi: 10.3390/cimb45100526.


DOI:10.3390/cimb45100526
PMID:37886969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10605822/
Abstract

Despite current advancements in chemotherapy, immunotherapy and targeted treatments, the potential for major adverse cardiovascular events, regardless of previous cardiac history, persists. Scoring systems, such as the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) risk assessment tool, can be utilized to evaluate several factors including prior cardiac history, risk factors and cardiac biomarkers to categorize patients into low, moderate, high, and very high-risk groups. Common cardiotoxicity complications include new or worsening left ventricular ejection fraction (LVEF), QT interval prolongation, myocardial ischaemia, hypertension, thromboembolic disease, cardiac device malfunction and valve disease. Baseline electrocardiogram (ECG) and transthoracic echocardiogram (TTE) are routinely performed for all patients commenced on cardiotoxic treatment, while other imaging modalities and biochemical markers have proven useful for monitoring. Management mainly includes early risk stratification and prompt identification of cardiovascular complications, with patient-specific surveillance throughout treatment. A multidisciplinary approach is crucial in determining the relationship between potential treatment benefits and cardiotoxicity, and whether the continuation of treatment is appropriate on a case-by-case basis. Early risk stratification, optimizing the patient's cardiovascular status prior to treatment, and prompt identification of suspected cardiotoxicity are key in significantly reducing risk. This article provides a comprehensive review of the various types of treatment-related cardiotoxicity, offering guidance on identifying high-risk patients, recognizing early signs of cardiotoxicity, and outlining appropriate treatment approaches and follow-up care for such cases.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42f/10605822/9315c39189f5/cimb-45-00526-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42f/10605822/09b9f1f2379c/cimb-45-00526-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42f/10605822/9315c39189f5/cimb-45-00526-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42f/10605822/09b9f1f2379c/cimb-45-00526-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42f/10605822/9315c39189f5/cimb-45-00526-g002.jpg

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Cardiac Toxicities in Oncology: Elucidating the Dark Box in the Era of Precision Medicine.

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[1]
Risk prediction of QTc prolongation occurrence in cancer patients treated with commonly used oral tyrosine kinase inhibitors: machine learning modeling or conventional statistical analysis better?

BMC Med Inform Decis Mak. 2025-8-15

[2]
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[3]
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[4]
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本文引用的文献

[1]
Mechanisms of trastuzumab induced cardiotoxicity - is exercise a potential treatment?

Cardiooncology. 2023-4-25

[2]
Temporary treatment cessation versus continuation of first-line tyrosine kinase inhibitor in patients with advanced clear cell renal cell carcinoma (STAR): an open-label, non-inferiority, randomised, controlled, phase 2/3 trial.

Lancet Oncol. 2023-3

[3]
Recent Advances in Serum Biomarkers for Risk Stratification and Patient Management in Cardio-Oncology.

Curr Cardiol Rep. 2023-3

[4]
Global Longitudinal Strain in Cardio-Oncology: A Review.

Cancers (Basel). 2023-2-3

[5]
130/80 mmHg as a unifying hypertension threshold for office brachial, office central, and ambulatory daytime brachial blood pressure.

J Clin Hypertens (Greenwich). 2023-3

[6]
Galectin-3 and Myeloperoxidase May Monitor Cancer-Therapy-Related Cardiotoxicity? A Systematic Review and Meta-Analysis.

Biomolecules. 2022-11-30

[7]
New Way to "SCORE" Risk: Updates on the ESC Scoring System and Incorporation into ESC Cardiovascular Prevention Guidelines.

Curr Cardiol Rep. 2022-11

[8]
Cardiac Biomarkers for the Detection and Management of Cancer Therapy-Related Cardiovascular Toxicity.

J Cardiovasc Dev Dis. 2022-10-29

[9]
A systematic review of miRNAs as biomarkers for chemotherapy-induced cardiotoxicity in breast cancer patients reveals potentially clinically informative panels as well as key challenges in miRNA research.

Cardiooncology. 2022-9-7

[10]
2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS).

Eur Heart J. 2022-11-1

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