Key result
Current management of cancer therapeutics-related cardiac dysfunction relies largely on data extrapolated from general heart failure populations, lacking strong evidence for newer targeted therapies.
Why the study?
Cardiovascular events and cancer therapeutics-related cardiac dysfunction cause morbidity and limit cancer therapy, yet management guidelines rely largely on extrapolated non-cancer heart failure data rather than strong evidence.
This review discusses the management of chemotherapy-associated cardiomyopathy, noting that current guidelines largely rely on data extrapolated from the general heart failure population.
Answers are grounded in this paper and cite their sources.
Urges caution extrapolating general HF data to cardio-oncology patients; leaves open need for dedicated trials on targeted therapies.
PURPOSE OF REVIEW: The number of cancer survivors is increasing, and cardiovascular events are a significant cause of morbidity and mortality in these patients. Preexisting cardiovascular conditions as well as the development of cancer therapeutics-related cardiac dysfunction (CTRCD), in particular left ventricular dysfunction and heart failure, limit the options for cancer therapies for these patients and contribute to reduced cancer survival. RECENT FINDINGS: Recent guidelines and position statements from various cardiology and oncology societies provide an outline for the practicing physician for the management of CTRCD. However, this is largely based on data extrapolated from the general heart failure population (including patients without cancers) and is not based on strong evidence. There is now emerging evidence for the prevention and treatment of heart failure related to certain established chemotherapeutic drugs, whereas there is lack of trials for specific cardioprotective strategies to reduce cardiotoxicity of newer targeted cancer therapies. SUMMARY: In this article, we discuss the most recent literature for the management of asymptomatic left ventricular dysfunction and heart failure related to chemotherapy, from prevention to the use of goal-directed medical therapies as well as discuss the role for advanced heart failure treatment in this population.
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Cai et al. (2019) conducted a review in Cancer therapeutics-related cardiac dysfunction (CTRCD). Cardioprotective strategies and goal-directed medical therapies was evaluated. Current management of cancer therapeutics-related cardiac dysfunction relies largely on data extrapolated from general heart failure populations, lacking strong evidence for newer targeted therapies.
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