Anthracycline-induced cardiotoxicity in patients with paediatric bone sarcoma and soft tissue sarcoma

Bini, Ilaria; Asaftei, Sebastian Dorin; Riggi, Chiara; Tirtei, Elisa; Manicone, Rosaria; Biasin, Eleonora; Basso, Maria Eleonora; Agnoletti, Gabriella

doi:10.1017/s1047951117001536

Cited by 14 publications

(24 citation statements)

References 32 publications

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“…Different chemotherapy agents cause cardiotoxicity through a wide variety of mechanisms, causing not only cardiomyopathy but also hypercoagulable states, arrhythmia, and inflammation [4]. Anthracyclines such as daunorubicin, doxorubicin, and mitoxantrone are the most well-studied and cause dose-dependent cardiomyopathy and congestive heart failure [1, 5–8]. These agents work against cancer by cross-linking topoisomerase IIα to DNA and directly intercalating with DNA, resulting in DNA damage, apoptosis, mitochondrial injury, increased reactive oxygen species [6], and programmed cell death [9].…”

Section: Chemotherapeutic Agents That Cause Cardiotoxicitymentioning

confidence: 99%

“…Despite recent advances in cancer treatment, cardiotoxicity can result from traditional chemotherapy agents such as anthracyclines, as well as newer targeted therapies, such as trastuzumab, leading to significant morbidity and mortality [1–4]. Radiation therapy alone and in combination with chemotherapy can also contribute to cardiotoxicity [5, 6].…”

Section: Introductionmentioning

confidence: 99%

“…The most common sign of chronic cardiotoxicity is asymptomatic systolic or diastolic dysfunction, leading to irreversible heart failure and even death [2], which makes close long-term monitoring by experienced healthcare providers critical. In one trial evaluating trastuzumab, cardiotoxicity was defined as one or more of the following: [1] cardiomyopathy characterized by a decrease in cardiac LVEF that was either global or more severe in the septum, [2] symptoms of congestive heart failure (CHF), [3] associated signs of CHF, including but not limited to S3 gallop, tachycardia, or both, and [4] decline in LVEF of at least 5% to less than 55% with accompanying signs or symptoms of CHF, or a decline in LVEF of at least 10% to below 55% without accompanying signs or symptoms [3]. However, cardiotoxic effects can range from coronary heart disease, pericardial disease, valvular disease, cardiomyopathy, and arrhythmias [7] and there are no standardized definitions or diagnostic criteria for cardiotoxicity.…”

Section: Introductionmentioning

confidence: 99%

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Pharmacogenetics of Chemotherapy-Induced Cardiotoxicity

Chang

Wang

2018

Curr Oncol Rep

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Most of the studies rely on in vitro cytotoxic assays. There have been several smaller scale candidate gene approaches and a handful of genome-wide studies linking genetic variation to susceptibility to chemotherapy-induced cardiotoxicity. Currently, pharmacogenomic testing of all childhood cancer patients with an indication for doxorubicin or daunorubicin therapy for RARG rs2229774, SLC28A3 rs7853758, and UGT1A6*4 rs17863783 variants is recommended. There is no recommendation regarding testing in adults. There is clear evidence pointing to the role of pharmacogenetics and pharmacogenomics in cardiotoxicity susceptibility to chemotherapeutic agents. Larger scale studies are needed to further identify susceptibility markers and to develop pharmacogenomics-based risk profiling to improve quality of life and life expectancy in cancer survivors.

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Section: Chemotherapeutic Agents That Cause Cardiotoxicitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pharmacogenetics of Chemotherapy-Induced Cardiotoxicity

Chang

Wang

2018

Curr Oncol Rep

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“…It is important for risk factors to be detected, which include: some polymorphisms, obesity, arterial hypertension, age younger than four years, female gender, metabolic syndrome, radiotherapy higher than 5 Gy, monoclonal antibodies, hematopoietic cell transplantation, mitoxantrone, 5-fluoroacil, alkylating agents such as cyclophosphamide, cisplatin, biological agents such as trastuzumab and rituximab, and tyrosine kinase inhibitors such as imatinib, sunitinib and dazatinib [8][9][10][11] . The factor that entails the highest risk in statistical analyses is anthracycline cumulative dose ≥ 300 mg/m 2 , with an incidence of up to 14.6%.…”

Section: Introductionmentioning

confidence: 99%

Importance of cardio-oncology. How to detect subclinical heart failure

Rubens-Figueroa¹,

Cárdenas-Cardós²

2021

ACME

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Today one of the main causes of mortality is cancer. Survival in cancer patients has increased from 1970 (25%) to the present (80%). Following the introduction of anthracyclines as a cancer treatment since 1960-70, more than 60% of patients are treated with these agents, although chemotherapeutic exposure leads to cardiovascular diseases as the main cause of mortality in surviving patients. of cancer in the s. XXI. There are multiple factors that increase the sensitivity of anthracyclic-induced cardiotoxicity. In 1970 the gold standard for the detection of ventricular dysfunction was endomyocardial biopsy, subsequently the detection and management of cardiotoxicity was guided by symptoms, in 1981 the detection of cardiotoxicity was reported with the determination of the ejection fraction of the left ventricle (LVEF), by 2D echocardiography. Currently, the 3D echocardiogram for LVEF and systolic and diastolic volumes have presented a high correlation of the values obtained by magnetic resonance imaging for the evaluation of cardiac function. Today strain, strain-rate and speckle tracking echocardiography are used to determine regional and global myocardial function. For a comprehensive assessment, these results can be complemented with cardiac biomarkers (troponins) and electrocardiographic changes. In this way, subclinical heart failure can be detected and timely treatment can be given.

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“…In general, treatment for lymphoma involves chemotherapy alone or in combination with radiation, stem cell transplantation, or biologic therapies . The long‐term cardio‐toxic effects of these treatments, especially chemotherapy regimens utilizing anthracyclines and radiation therapy, have become more apparent in cancer survivors over the past decade . We previously conducted a meta‐analysis and found that the number of deaths due to CVDs within HL and NHL survivors were 7.31 (95% CI, 5.29‐10.10) and 5.35 (95% CI, 2.55‐11.24) times greater than the general population, respectively .…”

Section: Introductionmentioning

confidence: 99%

Treatment for lymphoma and late cardiovascular disease risk: A systematic review and meta‐analysis

Stone

Mickle

Boyne

et al. 2019

Health Science Reports

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Background and aimsLymphoma patients are frequently treated with cancer therapies that may increase the risk of adverse health outcomes later in life, including cardiovascular disease (CVD) mortality. We sought to investigate the long‐term risk of CVD incidence in this survivor population relative to the general population to quantify this health burden.MethodsA systematic review and meta‐analysis was conducted using EMBASE, MEDLINE, and CINAHL databases, from date of inception to November 2016, with additional searches completed through June 2018. Included reports were observational studies assessing CVD incidence in patients of either Hodgkin or non‐Hodgkin lymphoma (HL, NHL) who survived for at least 5 years from the time of diagnosis or if the study had a median follow‐up of 10 years. Meta‐analyses were performed using random effects models, and subgroup analyses were conducted to determine the incidence of specific CVD subtypes (coronary heart disease, pericardial disease, valvular heart disease, myocardial disease, cardiac dysrhythmia, and cerebrovascular disease). Heterogeneity was assessed using I 2 statistics and prediction intervals.ResultsOf the 7734 studies identified, 22 studies were included in this review, representing 32 438 HL and NHL survivors. Relative to the general population, lymphoma survivors had statistically significant two to threefold increases in the risk for nearly all subtypes of CVD examined. Lymphoma survivors appeared to be particularly susceptible to pericardial diseases (HL: 10.67, 95% confidence interval (CI), 7.75‐14.69; NHL: 4.70, 95% CI, 2.08‐10.61) and valvular diseases (HL: 13.10, 95% CI, 7.41‐23.16; NHL: 3.76, 95% CI, 2.12‐6.66). Although the 95% CIs were suggestive of increased risks, the 95% prediction intervals often included the null, reflecting the high heterogeneity of the estimates.ConclusionGiven the suggested increased risks of cardiovascular outcomes in lymphoma survivor populations relative to the general population, tailored screening and prevention programmes may be warranted to offset the future burden of disease.

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Anthracycline-induced cardiotoxicity in patients with paediatric bone sarcoma and soft tissue sarcoma

Abstract: In our population, the cumulative incidence of cardiotoxicity is comparable to rates in the literature. This underlines the need for primary prevention and lifelong cardiac toxicity surveillance programmes in long-term childhood cancer survivors.

Cited by 14 publications

References 32 publications

Pharmacogenetics of Chemotherapy-Induced Cardiotoxicity

Pharmacogenetics of Chemotherapy-Induced Cardiotoxicity

Importance of cardio-oncology. How to detect subclinical heart failure

Treatment for lymphoma and late cardiovascular disease risk: A systematic review and meta‐analysis

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