%0 Journal Article
%T Cardiac Toxicities in the Era of Precision Medicine: Underlying Risk Factors, Targeted Therapies, and Cardiac Biomarkers
%A Anne H. Blaes
%A Javid Moslehi
%A Paaladinesh Thavendiranathan
%J About the Ed Book | ASCO Educational Book
%D 2018
%R https://doi.org/10.1200/EDBK_208509
%X Cardiac imaging with echocardiography should be considered in the follow-up period in all survivors at high risk for cardiomyopathy. For the last 4 decades, oncologists have been aware that some cancer treatments, particular chemotherapeutic agents and radiation, can result in cardiovascular complications, such as ischemic cardiovascular disease, cardiomyopathy, clinical heart failure, and arrhythmias. Although treatments options for patients with cancer have evolved with the introduction of new targeted therapies, there continues to be a growing appreciation of the cardiac toxicities of cancer therapies¡ªthus the emergence of a new field of ¡°cardio-oncology.¡±1-3 In parallel, there has been a rapid growth in the biologic understanding of cancer, molecular pathways, genetic susceptibility to cancer, and cancer syndromes as well as the toxicities of these therapies.4 Here, we present an overview of the development of cardio-oncology, the cardiac toxicity of new anticancer agents, and newer techniques, such as imaging and biomarkers, that can be used for the monitoring and prevention of cardiac complications of anticancer therapies. CARDIAC TOXICITIES IN THE ERA OF PRECISION MEDICINE Section: ChooseTop of pageAbstractCARDIAC TOXICITIES IN THE... <<CONCLUSIONReferences Overview of Cardiovascular Toxicities of Current Anticancer Therapies A number of chemotherapeutic agents can cause cardiomyopathy and heart failure (Table 1). Perhaps best studied are the anthracyclines. First described in the 1970s by Lefrak and colleagues,5 the incidence of anthryacycline-induced congestive heart failure is dose dependent, with an estimated 2% at 200 mg/m2, 5% at 400 mg/m2, 16% at 500 mg/m2, and 26% at 550 mg/m2.5 Other risk factors include female sex and extremes of age (affecting both younger and older patients).6 For those over the age of 65, there is a twofold increased risk of doxorubicin-induced congestive heart failure compared with in those younger than 65 when adjusting for a history of low/normal ejection fraction, gender, history of cardiac disease, and performance status.7 Similarly, in the Children¡¯s Oncology Group, the young seem particularly at risk for cardiac toxicity; childhood cancer survivors are at a 15-fold higher risk of cardiomyopathy compared with age-matched controls.8-10 The dose-dependent relationship of anthracyclines and heart failure in this patient population has also been well established, with an additional rising increase in those who also received chest radiation.9 Some literature suggest that liposomal formulation may result in less
%U http://ascopubs.org/doi/full/10.1200/EDBK_208509