A review of five ongoing cardio-oncology trials highlights the integration of cardiovascular endpoints to balance cardiovascular toxicity risks with cancer treatment efficacy.
There is a critical need for integrated cardio-oncology trial designs that simultaneously evaluate cancer treatment efficacy and cardiovascular toxicity.
Cardiovascular (CV) toxicity from cancer therapy is a significant and growing concern. Conventional oncology clinical trial designs focused singularly on cancer treatment efficacy have not provided sufficient information on both CV risk factors and outcomes. Similarly, traditional CV trials evaluating standard interventions typically exclude cancer patients, particularly those actively receiving cancer therapy. Neither trial type simultaneously evaluates the balance between CV toxicity and cancer outcomes. However, there is increasing collaboration among oncologists and cardiologists to design new cardio-oncology trials that address this important need. In this review, we detail five ongoing, oncology-based trials with integrated CV endpoints. Key design features include: 1) a careful assessment of baseline risk factors for CV disease; 2) an introduction of cardioprotective interventions at various timepoints in cancer therapy; 3) a balance of the risk of subclinical CV injury with the need for ongoing cancer treatment; and 4) an understanding of the time profile for development of clinically apparent CV toxicity. Additional critical priorities in cardio-oncology clinical research include harmonization of data collection and definitions for all physician- and patient-reported exposures and outcomes.
Minasian et al. (Sun,) conducted a review in Cancer treatment-related cardiovascular toxicity. Cardio-oncology trial designs was evaluated. A review of five ongoing cardio-oncology trials highlights the integration of cardiovascular endpoints to balance cardiovascular toxicity risks with cancer treatment efficacy.