Precision Cardio-Oncology: a Systems-Based Perspective on Cardiotoxicity of Tyrosine Kinase Inhibitors and Immune Checkpoint Inhibitors

Brown, Sherry‐Ann; Ray, Jordan; Herrmann, Joerg

doi:10.1007/s12265-020-09992-5

Cited by 19 publications

(10 citation statements)

References 116 publications

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“…37,85 Different degrees (high-level and lowlevel) of lymphohistiocytic myocardial inflammation can be seen, and the exact mechanisms of this presentation are not yet defined. 86 Confirmation of the diagnosis can be challenging because neither magnetic resonance imaging nor endomyocardial biopsy is sufficiently sensitive, and a diagnosis is often made based on the overall clinical picture (in keeping with proposed consensus definitions). 37,87,88 As SARS-CoV-2 can directly infect the myocardium, with a resultant inflammatory response, SARS-CoV-2 should be considered in the differential diagnosis of a patient with concern for ICI-associated myocarditis.…”

Section: Immune Checkpoint Inhibitorsmentioning

confidence: 99%

“…Although one of the least common irAEs, myocarditis with an ICI is one of the most fatal 37,85 . Different degrees (high‐level and low‐level) of lymphohistiocytic myocardial inflammation can be seen, and the exact mechanisms of this presentation are not yet defined 86 . Confirmation of the diagnosis can be challenging because neither magnetic resonance imaging nor endomyocardial biopsy is sufficiently sensitive, and a diagnosis is often made based on the overall clinical picture (in keeping with proposed consensus definitions) 37,87,88 .…”

Section: Specific Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Cardio‐oncology care in the era of the coronavirus disease 2019 (COVID‐19) pandemic: An International Cardio‐Oncology Society (ICOS) statement

Lenihan

Carver

Porter

et al. 2020

CA A Cancer J Clinicians

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has given rise to a pandemic of unprecedented proportions in the modern era because of its highly contagious nature and impact on human health and society: coronavirus disease 2019 (COVID-19). Patients with cardiovascular (CV) risk factors and established CV disease (CVD) are among those initially identified at the highest risk for serious complications, including death. Subsequent studies have pointed out that patients with cancer are also at high risk for a critical disease course. Therefore, the most vulnerable patients are seemingly those with both cancer and CVD, and a careful, unified approach in the evaluation and management of this patient population is especially needed in times of the COVID-19 pandemic. This review provides an overview of the unique implications of the viral outbreak for the field of cardiooncology and outlines key modifications in the approach to this ever-increasing patient population. These modifications include a shift toward greater utilization of cardiac biomarkers and a more focused CV imaging approach in the broader context of modifications to typical practice pathways. The goal of this strategic adjustment is to minimize the risk of SARS-CoV-2 infection (or other future viral outbreaks) while not becoming negligent of CVD and its important impact on the overall outcomes of patients who are being treated for cancer.

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Section: Immune Checkpoint Inhibitorsmentioning

confidence: 99%

Section: Specific Recommendationsmentioning

confidence: 99%

Cardio‐oncology care in the era of the coronavirus disease 2019 (COVID‐19) pandemic: An International Cardio‐Oncology Society (ICOS) statement

Lenihan

Carver

Porter

et al. 2020

CA A Cancer J Clinicians

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“…Inhibition of BTK causes downregulation of these downstream pathways and brings out B-cell-inhibiting effects. However, it also acts on 50 other tyrosine kinases in the body, contributing to many off-target effects seen with ibrutinib [ 8 ]. It has been known to cause hypertension and atrial fibrillation (8%) in many patients [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…This leads authors to propose a direct cellular effect of Ibrutinib on cardiac myocyte leading to cardiac dysfunction as the possible mechanism. Alteration of “off-target” intracellular signaling pathways, depletion of intracellular ATPs, the affliction of mitochondrial metabolism can be the potential factors causing cardiac dysfunction in our case [ 8 ]. Elevated ProBNP has been linked to TKIs [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Reversible Systolic Heart Failure in a Patient on Ibrutinib Chemotherapy

Khaja¹,

Gurjar²,

Yapor³

et al. 2022

Cureus

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Ibrutinib is an irreversible Bruton tyrosine kinase inhibitor that is approved for the treatment of mantle cell lymphoma, chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström macroglobulinemia, marginal zone lymphoma, and mantle cell lymphoma. However, it is associated with significant cardiotoxic effects, with hypertension and atrial fibrillation being the most common. We present the case of a 42-year-old female with a medical history significant for lymphoplasmacytic lymphoma who presented with non-arrhythmic, non-ischemic cardiomyopathy after four months of chemotherapy with ibrutinib. In addition, her left ventricular ejection fraction improved markedly within a few days of stopping ibrutinib. We propose that the use of ibrutinib may be associated with reversible non-ischemic cardiomyopathy even in the absence of cardiac arrhythmias. Therefore, clinicians should be cognizant of the signs and symptoms of cardiomyopathy in patients on ibrutinib chemotherapy.

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“…Bu yönüyle RT'nin sebep olduğu miyokard hasarı, uzun yıllar boyunca KEF-KY halinde kalabilir. [2,11] Bu hastalarda yapılan endomiyokardiyal biyopsilerde; KEF-KY'de, iskemik olmayan DEF-KY'ne benzer yapıda kollajen hücreler gösterilmiştir. [4] Kollajen; oksidatif ve mekanik stres, iskemi ve inflamasyon gibi çok sayıda birbirinden farklı patolojik uyarana cevaben özellikle fibroblastlarda ve vasküler düz kas hücrelerinde sentezlenir.…”

unclassified

Kemoterapiye bağlı gelişen DEF-KY’de sakubitril/valsartan’ın faydası olabilir mi?

Zorkun¹

2020

updates cardiol

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Precision Cardio-Oncology: a Systems-Based Perspective on Cardiotoxicity of Tyrosine Kinase Inhibitors and Immune Checkpoint Inhibitors

Cited by 19 publications

References 116 publications

Cardio‐oncology care in the era of the coronavirus disease 2019 (COVID‐19) pandemic: An International Cardio‐Oncology Society (ICOS) statement

Cardio‐oncology care in the era of the coronavirus disease 2019 (COVID‐19) pandemic: An International Cardio‐Oncology Society (ICOS) statement

Reversible Systolic Heart Failure in a Patient on Ibrutinib Chemotherapy

Kemoterapiye bağlı gelişen DEF-KY’de sakubitril/valsartan’ın faydası olabilir mi?

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