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  • br Bartlett FR Colgan RM Carr

    2020-08-28


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    Contents lists available at ScienceDirect
    International Journal of Cardiology
    Cardio-oncology - strategies for management of cancer-therapy related cardiovascular disease
    Matthias Totzeck a, Martin Schuler b,e, Martin Stuschke c,e, Gerd Heusch d, Tienush Rassaf a,
    a Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
    b Department of Medical Oncology, West German Cancer Center, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
    c Department of Radiation Oncology, West German Cancer Center, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
    d Institute for Pathophysiology, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
    e German Cancer Consortium (DKTK), Partner site University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany
    Article history:
    Keywords:
    Cancer survivorship
    Cancer therapy
    Cardio-oncology
    Cardiotoxicity 
    Current therapy of advanced cancers is based on several modalities including radiotherapy, cytotoxic chemother-apy, molecularly targeted inhibitors and antibodies targeting immune checkpoints. All of those these modalities can negatively impact the cardiovascular system, and there is considerable experience in relation to radiotherapy and chemotherapy. In contrast, the knowledge base on cardiovascular toxicities of novel agents targeting signal transduction pathways and immune regulation is quite limited. In particular, potential late effects are of concern as cardiovascular pathology can negatively impact quality of life and prognosis in cancer survivors, particularly when additional cardiovascular risk factors are present. Treatment-associated adverse events include hyperten-sion, venous thromboembolism, coronary artery disease, valvular heart disease, heart failure and arrhythmias. Early diagnosis of subclinical cardiotoxic effects of cancer therapies remains challenging. Integrated care, as pro-vided by multidisciplinary cardio-oncology teams is the best option for prevention, diagnosis and treatment of cardiovascular diseases associated with cancer therapy. This review considers the cardiotoxic effects of specific cancer therapies and discusses novel diagnostic and therapeutic approaches as a reference for optimizing the care of cancer patients receiving novel cancer therapies.