Evaluation of cardiotoxicity of anthracycline‐containing chemotherapy regimens in patients with bone and soft tissue sarcomas: A study of the FDA adverse event reporting system joint single‐center real‐world experience

Figures

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  FIGURE 1. Distribution of essential clinical characteristics of patients receiving anthracycline‐containing chemotherapy from FAERS database. (A) Mulberry map of clinical characteristics of patients with doxorubicin (ADM), epirubicin (EPI), and liposomal doxorubicin (L‐ADM). Data were collected from drugs, age, sex, outcome (OUTC_COD), and cancer types (INDI_PT). (B) Overlapping Wayne plots of individual identities of patients treated with three medications based on PRIMARYID values. (C) Distribution of countries and number of cases of patients included in all reported adverse events (AEs) for the three drugs. (D) The application frequency of anthracyclines was counted. NS indicates those not explicitly stated in the factor.

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  FIGURE 2. Distribution of types of cardiac disorders and comparison of the likelihood of adverse events (AEs) between different subgroups. (A) Heat map distribution of the types of suspected anthracycline‐related AEs in the different system organ classes (SOCs). (B) Univariate logistic regression analyses were performed with the MHRA signal as the dependent variable. (C) Multivariate logistic regression analyses were performed with the MHRA signal as the dependent variable. (D) AEs related to cardiac disorders of ADM were included for analysis, and multivariate logistic regression analyses were performed.

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  FIGURE 3. Frequency and population share of common cardiac disorders‐related adverse events (AEs) for three anthracyclines and comparison of the differences in sarcomas and breast cancer (BC). (A–C) The number, percentage, and specific PRR values of cardiac disorders‐related AEs were visualized. (D) The frequency and the percentage of common cardiac disorders reported with the same cancer type were compared separately.

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  FIGURE 4. Comparison of the likelihood of cardiac failure between the dexrazoxane and non‐dexrazoxane groups. (A) Pie chart visualizing the percentage of different “preferred terms” in the number of all heart diseases between the dexrazoxane and non‐dexrazoxane groups. (B) The Wilcoxon test compares cardiac failure between the dexrazoxane and non‐dexrazoxane groups in all‐tumor species, sarcomas, or leukemias. (C) Pie chart visualizing the percentage of different “preferred terms” in the number of all heart diseases in adolescents with tumors. (D) The Wilcoxon test compares cardiac failure between the dexrazoxane and non‐dexrazoxane groups in different ages and ADM concentrations. p < 0.05 were considered statistically significant.

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  FIGURE 5. Distribution of essential clinical characteristics of patients receiving anthracycline‐containing chemotherapy from our single center. (A) Density plot of the number of patients with STBSs who received anthracycline‐containing therapy. (B) Mulberry map of clinical characteristics of patients with ADM, EPI, and L‐ADM. (C) The number and percentage of different tumor types in patients treated with anthracyclines were counted separately. (D) Overlapping Wayne plots of individual identities of patients treated with three medications based on the unique identification ID of patients.

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  FIGURE 6. Evaluation of cardiotoxicity‐related markers in patients with STBSs at our center. (A, B) Comparison of differences between different drug groups that developed abnormal NT‐ProBNP or TPN‐T values after receiving anthracycline‐containing chemotherapy. The numbers in the blue and red boxes represent the number of patients with normal serum NT‐ProBNP or TPN‐T values, and the numbers in the red boxes represent the number of patients with abnormal serum NT‐ProBNP or TPN‐T values. (C) In the left ventricular ejection fraction (LVEF) assay, the difference between the first‐measurement baseline values compared to the last‐measurement values (the value with the largest decrease in LVEF was selected if three or more detection event points existed) was compared. (D) Overlapping Wayne plots of abnormal markers based on unique identification ID of patients.