Stratification and management of cardiovascular risk in cancer patients. A consensus document of the SEC, FEC, SEOM, SEOR, SEHH, SEMG, AEEMT, AEEC, and AECC

Martín-García, Ana; Mitroi, Cristina; Ramos, Pilar Mazón; Sanz, Ramón Garcí­a; Virizuela, Juan Antonio; Arenas, Meritxell; Cabello, Isabel Egocheaga; Albert, Dimpna C.; Sánchez, Manuel Anguita; Esteban, Vicente Ignacio Arrarte; Peña, Francisco Ayala de la; Lozano, C.; Castro, Almudena; Fernández, Antonio; Cosı́n-Sales, Juan; Chaparro-Muñoz, Marinela; Dalmau, Regina; Hernandez, Yasmin; Bronte, L. Deiros; Díez‐Villanueva, Pablo; Cervantes, C. Escobar; Redondo, Concepción Fernández; Rodríguez, Estíbaliz García; Lozano, Teresa; Vera, Pascual Marco; Monzonís, A. Martínez; Mesa, Dolores; Oristrell, Gerard; Gámiz, José Luis Palma; Pedreira, Milagros; Reinoso-Barbero, Luis; Rodríguez, Isabel; Antolín, José María Serrano; Toral, Belén; Royò, Laura Torres; Castillo, Sonia Velasco del; Vicente-Herrero, Teófila; Zataraín-Nicolás, Eduardo; Tamargo, Juan; Fernández, Teresa López

doi:10.1016/j.rec.2020.11.020

Cited by 12 publications

(10 citation statements)

References 80 publications

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“…Age and CVRF and lifetime risk calculators) may be considered at baseline for the assessment of CV risk, considering that cancer itself may increase the likelihood of CVD. 19,23,30,31 Baseline risk assessment should be considered by the treating oncology or haematology team for all patients diagnosed with cancer who are scheduled to receive a cancer treatment identified to have a clinically significant level of CRT-CVT, or by a cardiologist if appropriate. In the case of patients scheduled to receive anthracycline chemotherapy, the total planned cumulative anthracycline dose is also relevant, and ≥250 mg/m 2 of doxorubicin or equivalent should be considered higher risk (Table 5).…”

Section: General Approach To Cardiovascular Toxicity Risk In Patients...mentioning

confidence: 99%

“…4,131,132 The first step is to optimize lifestyle CVRF, smoking cessation, restricting alcohol consumption to a maximum of 100 g per week, and maintaining adequate physical activity. 30 Exercise prescription seems to be a promising treatment to counteract anticancer treatment side effects and different types of training can be prescribed during cancer therapy according to a patient's individual characteristics. 133 A healthy lifestyle decreases the risks of cancer, CVD, and transition from diagnosed cancer to subsequent CVD.…”

Section: General Principlesmentioning

confidence: 99%

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2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)

Lyon¹,

López‐Fernández²,

Couch³

et al. 2022

European Heart Journal

1,091

934

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Coronary care unit CDK Cyclin-dependent kinase CHA 2 DS 2 -VASc Congestive heart failure, Hypertension, Age ≥ 75 years (2 points), Diabetes mellitus, Stroke (2 points)-Vascular disease, Age 65-74 years, Sex category (female) CIED Cardiac implantable electronic device CML Chronic myeloid leukaemia CMR Cardiac magnetic resonance COMPASS-CAT Prospective COmparison of Methods for thromboembolic risk assessment with clinical Perceptions and AwareneSS in real-life patients-Cancer Associated Thrombosis CPET Cardiopulmonary exercise testing CrCl Creatinine clearance CRF Cardiorespiratory fitness CRS Cytokine release syndrome CS Cancer survivors CT Computed tomography CTLA-4 Cytotoxic T lymphocyte-associated antigen-4 cTn Cardiac troponin CTRCD Cancer therapy-related cardiac dysfunction CTR-CVT Cancer therapy-related cardiovascular toxicity CV Cardiovascular CVD Cardiovascular disease CVRF Cardiovascular risk factorsData derived from a single randomized clinical trial or large non-randomized studies.Consensus of opinion of the experts and/or small studies, retrospective studies, registries.©ESC 2022 ESC Guidelines © ESC 2022This table refers to anthracycline equivalence dose using doxorubicin as a reference. Note that these isoequivalent doses are derived from paediatric CS. CS, cancer survivors; CV, cardiovascular.a Data for idarubicin are based upon an estimated anticancer efficacy ratio, not derived from cardiotoxicity data. The CV toxicity dose ratio provides the value that should be used to multiply the dose of the anthracycline of interest to convert to isoequivalent doses of doxorubicin; e.g. to convert 125 mg/m 2 of epirubicin to doxorubicin isoequivalent, multiply the dose by 0.8 (125 mg/m 2 × 0.8 = 100 mg/m 2 of doxorubicin).

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Section: General Approach To Cardiovascular Toxicity Risk In Patients...mentioning

confidence: 99%

Section: General Principlesmentioning

confidence: 99%

2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)

Lyon¹,

López‐Fernández²,

Couch³

et al. 2022

European Heart Journal

1,091

934

View full text Add to dashboard Cite

show abstract

“… 42 Furthermore, all patients should be encouraged to maintain physical activity, and if applicable, quit smoking and restrict their alcohol consumption. 43 If the time between screening and TIL treatment is long, it is recommended to repeat cardiac serum biomarkers to identify subclinical cardiac injury during TIL treatment. 42 …”

Section: Discussionmentioning

confidence: 99%

Clinical presentation of cardiac symptoms following treatment with tumor-infiltrating lymphocytes: diagnostic challenges and lessons learned

Borgers,

van Schijndel,

van Thienen

et al. 2024

ESMO Open

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“…According to the Cardio-Oncology Consensus Document prepared in collaboration with the Spanish Societies of Cardiology, Medical Oncology, Radiation Oncology, and the Spanish Society of Hematology, 21 in the presence of HF, it is necessary to individualize the indication for suspending/delaying cancer treatment, assessing the risk of HF versus the risk of cancer recurrence/progression. The osimertinib summary of product characteristics recommends the temporary discontinuation of osimertinib if a grade 3 adverse event according to the CTCAE v5.0 classification occurs or if there are symptoms or signs of severe arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Possible heart failure caused by osimertinib in a lung cancer patient

Ruiz-Briones

Escudero‐Vilaplana

Collado-Borrell

et al. 2022

J Oncol Pharm Pract

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Introduction Osimertinib is a third-generation tyrosine kinase inhibitor (TKI) indicated for the treatment of epidermal growth factor receptor mutated non-small cell lung cancer (NSCLC). It has demonstrated better results concerning effectiveness than other TKIs for the same indication. However, despite a good safety profile, it could produce some cardiotoxicity that does not occur with other drugs of the same group. Case report We report the evolution and management of a female patient diagnosed with NSCLC who developed a grade 3 cardiotoxicity due to treatment with osimertinib. This patient suffered from a left bundle branch block, dyslipidemia, and hypertension as cardiovascular risk factors. After a long period of treatment with osimertinib, she developed a severe heart failure (HF) with an important decrease in left ventricular ejection fraction (LVEF), which triggered an admission to the oncology unit for eight days. Management and outcomes Treatment with osimertinib was first suspended and then resumed after stabilization of the HF. She also developed atrial fibrillation during admission and has required narrow cardiac monitoring and management since the debut of the HF. After evaluating the benefit-risk balance, osimertinib was reintroduced and the patient continues in treatment at the moment, although the baseline LVEF is not recovered. Discussion There is scarce evidence in the literature concerning HF and important LVEF decrease due to osimertinib. However, its severity and repercussion for the patient justify the thorough screening of cardiovascular risk factors before starting the therapy.

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Stratification and management of cardiovascular risk in cancer patients. A consensus document of the SEC, FEC, SEOM, SEOR, SEHH, SEMG, AEEMT, AEEC, and AECC

Cited by 12 publications

References 80 publications

2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)

2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)

Clinical presentation of cardiac symptoms following treatment with tumor-infiltrating lymphocytes: diagnostic challenges and lessons learned

Possible heart failure caused by osimertinib in a lung cancer patient

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