Cardiac dysfunction after cancer treatment

Abstract

Onco-cardiology is an evolving discipline that requires the consideration of cardiotoxicity in preclinical, clinical,and therapeutic aspects of protocol development,treatment, and surveillance of patients who have undergone interventions using cardiotoxic agents. Only then can we foster new ways to maximize survival while keeping cardiac damage within acceptable limits. It is to this end that our working together has brought us to our present understanding. In the future, we may expect onco-cardiology to play an even greater role in the care of cancer patients.

Figures

Fig. 1 The relationship between the observed incidence of heart failure (HF) and the time between the administration of doxorubicin and trastuzumab in the pivotal and adjuvant trastuzumab trials. In the FinHer Trial (Finland Herceptin Study9), trastuzumab preceded the anthracycline; in the metastatic study (a Single Agent in First-Line Treatment of HER2-Overexpressing Metastatic Breast Cancer10), the drugs were given concomitantly; in the NSABP B-31 trial (National Surgical Adjuvant Breast and Bowel Project B-3111) and the BCIRG 006 (Breast Cancer International Research Group 00612), trastuzumab was given about 30 days after the anthracycline; in the NCCTG N9831 (North Central Cancer Treatment Group N9831 adjuvant breast cancer trial13) the interval was approximately 60 days; and in the HERA trial (Herceptin Adjuvant Trial14), the interval was approximately 90 days. Modified from Ewer MS, Ewer SM. Cardiotoxicity of anticancer treatments: what the cardiologist needs to know. Nat Rev Cardiol 2010;7(10):564–75.