Cardiovascular Complications of Novel Multiple Myeloma Treatments

Li, Weijuan; Cornell, Robert F.; Lenihan, Daniel J.; Slosky, David A.; Jagasia, Madan; Piazza, Gregory; Moslehi, Javid

doi:10.1161/circulationaha.115.018351

Cited by 42 publications

(30 citation statements)

References 23 publications

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“…The course of this patient's treatment with recurrent dyspnea following carfilzomib treatments was unique given the consistent reproducibility of her symptoms immediately following her infusions, which would wax and wane with her biomarker trends. Most cases of suspected carfilzomib induced heart failure in the literature were not rechallenged, with a minority of cases undergoing a lower dose of carfilzomib infusions afterwards [6,7]. The patient also did not have any significant risk factors for cardiovascular disease-which was also confirmed on invasive coronary angiography-with only dyslipidemia and a remote tobacco history.…”

Section: Discussionmentioning

confidence: 91%

“…The degree of heart failure has been described in various degrees of severity, and has been characterized by LV systolic dysfunction with echocardiographic indices of diastolic dysfunction, although heart failure with preserved ejection fraction is uncommon. [6,7]. Mechanisms of how cardiotoxicity is caused is unclear, but theoretical mechanisms include pro-apoptotic actions via induction of capase-3/7, as well as inhibition of the chymotrypsin-like activity of myocyte lysate, which contributes to protein turnover in the heart [8] and possible endothelial dysfunction [9].…”

Section: Discussionmentioning

confidence: 99%

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Recurrent heart failure with preserved ejection fraction associated with carfilzomib administration for multiple myeloma

Yang¹,

Courtney

Garg³

et al. 2018

Cardio-Oncology

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Carfilzomib, an epoxyketone proteasome inhibitor, has demonstrated improved progression-free survival in patients when used with standard treatment (lenalidomide and dexamethasone) in patients with relapsed multiple myeloma (MM). However, there are reports of adverse cardiac events with carfilzomib manifested by dyspnea and heart failure. A patient is presented who had recurrent, clinically mild cardiotoxicity, as manifested by recurrent heart failure with preserved ejection fraction, with ongoing maintenance carfilzomib in a patient with resistant MM is presented.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Recurrent heart failure with preserved ejection fraction associated with carfilzomib administration for multiple myeloma

Yang¹,

Courtney

Garg³

et al. 2018

Cardio-Oncology

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“…Cardiac toxicities associated with conventional chemotherapy and radiotherapy are well known, and to a certain degree, the cellular and molecular mechanisms leading to cardiotoxicity have been discovered. Similar adverse cardiac events are encountered when applying MTTs, which represent a new generation of anticancer drugs . The MTTs that have received US FDA approval since their initiation in 2001 are listed in Tables , and .…”

Section: Introductionmentioning

confidence: 90%

“…VEGFR Colorectal Cancer, RCC SR4, 7,9,10,16,25,27,40,102,103,110 Vectibix [7][8][9][10]12,16,25,27,31,35,40,42,102,103,[115][116][117][118][119] Xgeva complications now threaten to offset some of the favorable benefits of these novel cancer treatments in cancer-related survival and strongly impact the quality of life regardless of the oncologic prognosis. [75][76][77] Additionally, effective clinical management remains quite challenging because no evidence-based approaches are currently available for the effective monitoring and treatment of these patients.…”

mentioning

confidence: 99%

Breakthroughs in modern cancer therapy and elusive cardiotoxicity: Critical research‐practice gaps, challenges, and insights

Zheng

Kros

2017

Medicinal Research Reviews

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To date, five cancer treatment modalities have been defined. The three traditional modalities of cancer treatment are surgery, radiotherapy, and conventional chemotherapy, and the two modern modalities include molecularly targeted therapy (the fourth modality) and immunotherapy (the fifth modality). The cardiotoxicity associated with conventional chemotherapy and radiotherapy is well known. Similar adverse cardiac events are resurging with the fourth modality. Aside from the conventional and newer targeted agents, even the most newly developed, immune‐based therapeutic modalities of anticancer treatment (the fifth modality), e.g., immune checkpoint inhibitors and chimeric antigen receptor (CAR) T‐cell therapy, have unfortunately led to potentially lethal cardiotoxicity in patients. Cardiac complications represent unresolved and potentially life‐threatening conditions in cancer survivors, while effective clinical management remains quite challenging. As a consequence, morbidity and mortality related to cardiac complications now threaten to offset some favorable benefits of modern cancer treatments in cancer‐related survival, regardless of the oncologic prognosis. This review focuses on identifying critical research‐practice gaps, addressing real‐world challenges and pinpointing real‐time insights in general terms under the context of clinical cardiotoxicity induced by the fourth and fifth modalities of cancer treatment. The information ranges from basic science to clinical management in the field of cardio‐oncology and crosses the interface between oncology and onco‐pharmacology. The complexity of the ongoing clinical problem is addressed at different levels. A better understanding of these research‐practice gaps may advance research initiatives on the development of mechanism‐based diagnoses and treatments for the effective clinical management of cardiotoxicity.

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“…Both patient-and drug-related factors have been implicated in this variability. 19 The prophylactic use of aspirin for low-risk patients and anticoagulation with either low molecular weight heparin or warfarin for high-risk patients is generally recommended. 15,20 Cisplatin, erlotinib and bevacizumab have also been reported to increase the risk for thrombotic events but there are no special recommendations for thrombosis prophylaxis.…”

Section: Thromboembolic Diseasementioning

confidence: 99%

Cardio-oncology: A Focus on Cardiotoxicity

Koutsoukis¹,

Ntalianis²,

Repasos³

et al. 2018

European Cardiology Review

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Cardio-oncology is a recently developed field in cardiology aimed at significantly reducing cardiovascular morbidity and mortality and improving quality of life in cancer survivors. Cancer survival rates have been constantly increasing, mainly because of the advent of new, more potent and targeted therapies. However, many of the new therapies – along with some of the older chemotherapeutic regimens such as anthracyclines – are potentially cardiotoxic, which is reflected increasingly frequently in the published literature. Cardiotoxicity adversely affects prognosis in cancer patients, thus its prevention and treatment are crucial to improve quality and standards of care. This review aims to explore the existing literature relating to chemotherapy- and radiotherapy-induced cardiotoxicity. An overview of the imaging modalities for the identification of cardiotoxicity and therapies for its prevention and management is also provided.

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Cardiovascular Complications of Novel Multiple Myeloma Treatments

Cited by 42 publications

References 23 publications

Recurrent heart failure with preserved ejection fraction associated with carfilzomib administration for multiple myeloma

Recurrent heart failure with preserved ejection fraction associated with carfilzomib administration for multiple myeloma

Breakthroughs in modern cancer therapy and elusive cardiotoxicity: Critical research‐practice gaps, challenges, and insights

Cardio-oncology: A Focus on Cardiotoxicity

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