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Cardiac toxicities in oncology: Elucidating the dark box in the era of precision medicine

Samuel, Younan, Babu, Aswin, Karagkouni, Foteini, Ismail, Ayden, Choi, Sunyoung, Boussios, Stergios (2023) Cardiac toxicities in oncology: Elucidating the dark box in the era of precision medicine. Current issues in molecular biology, 45 (10). pp. 8337-8358. ISSN 1467-3037. E-ISSN 1467-3045. (doi:10.3390/cimb45100526) (KAR id:103667)


Despite current advancements in chemotherapy, immunotherapy and targeted treatments, the potential for major adverse cardiovascular events, regardless of previous cardiac history, persists. Scoring systems, such as the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) risk assessment tool, can be utilized to evaluate several factors including prior cardiac history, risk factors and cardiac biomarkers to categorize patients into low, moderate, high, and very high-risk groups. Common cardiotoxicity complications include new or worsening left ventricular ejection fraction (LVEF), QT interval prolongation, myocardial ischaemia, hypertension, thromboembolic disease, cardiac device malfunction and valve disease. Baseline electrocardiogram (ECG) and transthoracic echocardiogram (TTE) are routinely performed for all patients commenced on cardiotoxic treatment, while other imaging modalities and biochemical markers have proven useful for monitoring. Management mainly includes early risk stratification and prompt identification of cardiovascular complications, with patient-specific surveillance throughout treatment. A multidisciplinary approach is crucial in determining the relationship between potential treatment benefits and cardiotoxicity, and whether the continuation of treatment is appropriate on a case-by-case basis. Early risk stratification, optimizing the patient's cardiovascular status prior to treatment, and prompt identification of suspected cardiotoxicity are key in significantly reducing risk. This article provides a comprehensive review of the various types of treatment-related cardiotoxicity, offering guidance on identifying high-risk patients, recognizing early signs of cardiotoxicity, and outlining appropriate treatment approaches and follow-up care for such cases.

Item Type: Article
DOI/Identification number: 10.3390/cimb45100526
Uncontrolled keywords: cardiotoxicity; chemotherapy; immunotherapy; targeted therapy; heart failure; cardiovascular disease
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: University of Kent (
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 21 Mar 2024 15:59 UTC
Last Modified: 22 Mar 2024 11:06 UTC
Resource URI: (The current URI for this page, for reference purposes)

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