Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations

G. Curigliano; D. Lenihan; M. Fradley; S. Ganatra; A. Barac; A. Blaes; J. Herrmann; C. Porter; A. R. Lyon; P. Lancellotti; A. Patel; J. DeCara; J. Mitchell; E. Harrison; J. Moslehi; R. Witteles; M. G. Calabro; R. Orecchia; E. de Azambuja; J. L. Zamorano; R. Krone; Z. Iakobishvili; J. Carver; S. Armenian; B. Ky; D. Cardinale; C. M. Cipolla; S. Dent; K. Jordan

doi:10.1016/j.annonc.2019.10.023

Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations

G. Curigliano, D. Lenihan, M. Fradley, S. Ganatra, A. Barac, A. Blaes, J. Herrmann, C. Porter, A. R. Lyon, P. Lancellotti, A. Patel, J. DeCara, J. Mitchell, E. Harrison, J. Moslehi, R. Witteles, M. G. Calabro, R. Orecchia, E. de Azambuja, J. L. ZamoranoR. Krone, Z. Iakobishvili, J. Carver, S. Armenian, B. Ky, D. Cardinale, C. M. Cipolla, S. Dent, K. Jordan

Cardiovascular Medicine

Research output: Contribution to journal › Article › peer-review

112 Scopus citations

Abstract

Cancer and cardiovascular (CV) disease are the most prevalent diseases in the developed world. Evidence increasingly shows that these conditions are interlinked through common risk factors, coincident in an ageing population, and are connected biologically through some deleterious effects of anticancer treatment on CV health. Anticancer therapies can cause a wide spectrum of short- and long-term cardiotoxic effects. An explosion of novel cancer therapies has revolutionised this field and dramatically altered cancer prognosis. Nevertheless, these new therapies have introduced unexpected CV complications beyond heart failure. Common CV toxicities related to cancer therapy are defined, along with suggested strategies for prevention, detection and treatment. This ESMO consensus article proposes to define CV toxicities related to cancer or its therapies and provide guidance regarding prevention, screening, monitoring and treatment of CV toxicity. The majority of anticancer therapies are associated with some CV toxicity, ranging from asymptomatic and transient to more clinically significant and long-lasting cardiac events. It is critical however, that concerns about potential CV damage resulting from anticancer therapies should be weighed against the potential benefits of cancer therapy, including benefits in overall survival. CV disease in patients with cancer is complex and treatment needs to be individualised. The scope of cardio-oncology is wide and includes prevention, detection, monitoring and treatment of CV toxicity related to cancer therapy, and also ensuring the safe development of future novel cancer treatments that minimise the impact on CV health. It is anticipated that the management strategies discussed herein will be suitable for the majority of patients. Nonetheless, the clinical judgment of physicians remains extremely important; hence, when using these best clinical practices to inform treatment options and decisions, practitioners should also consider the individual circumstances of their patients on a case-by-case basis.

Original language	English (US)
Pages (from-to)	171-190
Number of pages	20
Journal	Annals of Oncology
Volume	31
Issue number	2
DOIs	https://doi.org/10.1016/j.annonc.2019.10.023
State	Published - Feb 2020

Keywords

Clinical Practice Guidelines
cardiac disease
cardiovascular toxicity
diagnosis
recommendations

ASJC Scopus subject areas

Hematology
Oncology

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10.1016/j.annonc.2019.10.023

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Curigliano, G., Lenihan, D., Fradley, M., Ganatra, S., Barac, A., Blaes, A., Herrmann, J., Porter, C., Lyon, A. R., Lancellotti, P., Patel, A., DeCara, J., Mitchell, J., Harrison, E., Moslehi, J., Witteles, R., Calabro, M. G., Orecchia, R., de Azambuja, E., ... Jordan, K. (2020). Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Annals of Oncology, 31(2), 171-190. https://doi.org/10.1016/j.annonc.2019.10.023

Curigliano, G, Lenihan, D, Fradley, M, Ganatra, S, Barac, A, Blaes, A, Herrmann, J, Porter, C, Lyon, AR, Lancellotti, P, Patel, A, DeCara, J, Mitchell, J, Harrison, E, Moslehi, J, Witteles, R, Calabro, MG, Orecchia, R, de Azambuja, E, Zamorano, JL, Krone, R, Iakobishvili, Z, Carver, J, Armenian, S, Ky, B, Cardinale, D, Cipolla, CM, Dent, S & Jordan, K 2020, 'Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations', Annals of Oncology, vol. 31, no. 2, pp. 171-190. https://doi.org/10.1016/j.annonc.2019.10.023

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title = "Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations",

abstract = "Cancer and cardiovascular (CV) disease are the most prevalent diseases in the developed world. Evidence increasingly shows that these conditions are interlinked through common risk factors, coincident in an ageing population, and are connected biologically through some deleterious effects of anticancer treatment on CV health. Anticancer therapies can cause a wide spectrum of short- and long-term cardiotoxic effects. An explosion of novel cancer therapies has revolutionised this field and dramatically altered cancer prognosis. Nevertheless, these new therapies have introduced unexpected CV complications beyond heart failure. Common CV toxicities related to cancer therapy are defined, along with suggested strategies for prevention, detection and treatment. This ESMO consensus article proposes to define CV toxicities related to cancer or its therapies and provide guidance regarding prevention, screening, monitoring and treatment of CV toxicity. The majority of anticancer therapies are associated with some CV toxicity, ranging from asymptomatic and transient to more clinically significant and long-lasting cardiac events. It is critical however, that concerns about potential CV damage resulting from anticancer therapies should be weighed against the potential benefits of cancer therapy, including benefits in overall survival. CV disease in patients with cancer is complex and treatment needs to be individualised. The scope of cardio-oncology is wide and includes prevention, detection, monitoring and treatment of CV toxicity related to cancer therapy, and also ensuring the safe development of future novel cancer treatments that minimise the impact on CV health. It is anticipated that the management strategies discussed herein will be suitable for the majority of patients. Nonetheless, the clinical judgment of physicians remains extremely important; hence, when using these best clinical practices to inform treatment options and decisions, practitioners should also consider the individual circumstances of their patients on a case-by-case basis.",

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AU - Ganatra, S.

AU - Barac, A.

AU - Blaes, A.

AU - Herrmann, J.

AU - Porter, C.

AU - Lyon, A. R.

AU - Lancellotti, P.

AU - Patel, A.

AU - DeCara, J.

AU - Mitchell, J.

AU - Harrison, E.

AU - Moslehi, J.

AU - Witteles, R.

AU - Calabro, M. G.

AU - Orecchia, R.

AU - de Azambuja, E.

AU - Zamorano, J. L.

AU - Krone, R.

AU - Iakobishvili, Z.

AU - Carver, J.

AU - Armenian, S.

AU - Ky, B.

AU - Cardinale, D.

AU - Cipolla, C. M.

AU - Dent, S.

AU - Jordan, K.

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N2 - Cancer and cardiovascular (CV) disease are the most prevalent diseases in the developed world. Evidence increasingly shows that these conditions are interlinked through common risk factors, coincident in an ageing population, and are connected biologically through some deleterious effects of anticancer treatment on CV health. Anticancer therapies can cause a wide spectrum of short- and long-term cardiotoxic effects. An explosion of novel cancer therapies has revolutionised this field and dramatically altered cancer prognosis. Nevertheless, these new therapies have introduced unexpected CV complications beyond heart failure. Common CV toxicities related to cancer therapy are defined, along with suggested strategies for prevention, detection and treatment. This ESMO consensus article proposes to define CV toxicities related to cancer or its therapies and provide guidance regarding prevention, screening, monitoring and treatment of CV toxicity. The majority of anticancer therapies are associated with some CV toxicity, ranging from asymptomatic and transient to more clinically significant and long-lasting cardiac events. It is critical however, that concerns about potential CV damage resulting from anticancer therapies should be weighed against the potential benefits of cancer therapy, including benefits in overall survival. CV disease in patients with cancer is complex and treatment needs to be individualised. The scope of cardio-oncology is wide and includes prevention, detection, monitoring and treatment of CV toxicity related to cancer therapy, and also ensuring the safe development of future novel cancer treatments that minimise the impact on CV health. It is anticipated that the management strategies discussed herein will be suitable for the majority of patients. Nonetheless, the clinical judgment of physicians remains extremely important; hence, when using these best clinical practices to inform treatment options and decisions, practitioners should also consider the individual circumstances of their patients on a case-by-case basis.

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Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations

Abstract

Keywords

ASJC Scopus subject areas

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