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Systemic adverse effects and toxicities associated with immunotherapy: A review.

Immunotherapy is rapidly evolving secondary to the advent of newer immunotherapeutic agents and increasing approval of the current agents by the United States Food and Drug Administration to treat a wide spectrum of cancers. Immunotherapeutic agents have gained immense popularity due to their tumor-specific action. Immunotherapy is slowly transforming into a separate therapeutic entity, and the fifth pillar of management for cancers alongside surgery, radiotherapy, chemotherapy, and targeted therapy. However, like any therapeutic entity it has its own adverse effects. With the increasing use o

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… Structural cardiotoxicity secondary to the use of immunotherapy may be life-threatening and high suspicion for early recognition is imperative to prevent adverse outcomes. The cause of cardiotoxicity due to immunotherapy is still largely under investigation. … Cardiotoxicity danger in immunotherapy. IUBMB Life. 2020;72:1160–1167. doi: 10.1002/iub.2299. 13. Ganatra S, Parikh R, Neilan TG. Cardiotoxicity of Immune Therapy. Cardiol Clin. 2019;37:385–397. doi: 10.1016/j.ccl.2019.07.008. 14. Ala CK, Klein AL, Moslehi JJ. …

Ventricular Arrhythmia in Cancer Patients: Mechanisms, Treatment Strategies and Future Avenues.

Cardiovascular disease and cancer are the leading causes of morbidity and mortality in the US. Despite the significant progress made in cancer treatment leading to improved prognosis and survival, ventricular arrhythmias (VA) remain a known cardiovascular complication either exacerbated or induced by the direct and indirect effects of both traditional and novel cancer treatments. Although interruption of cancer treatment because of VA is rarely required, knowledge surrounding this issue is essential for optimising the overall care of patients with cancer. The mechanisms of cancer-therapeutic-i

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… Update on cardio-oncology: novel cancer therapeutics and associated cardiotoxicities. Trends Cardiovasc Med. 2019;29:29–39. doi: 10.1016/j.tcm.2018.06.001. 56. Shah RR, Morganroth J, Shah DR. … Clinical features, management, and outcomes of immune checkpoint inhibitor-related cardiotoxicity. Circulation. 2017;136:2085–7. doi: 10.1161/CIRCULATIONAHA.117.030571. 67. Stein-Merlob AF, Hsu JJ, Colton B et al. …

Cardiovascular health: an important component of cancer survivorship.

Advances in the detection and treatment of cancer have translated into improved cancer survival rates and a growing population of cancer survivors. These include those living with cancer and individuals free of the disease following treatment. Epidemiological studies demonstrate that cancer survivors are at an increased risk of cardiovascular disease (CVD), with cardiovascular (CV) mortality overtaking cancer mortality in some tumour types. Cancer and CVD share common aetiological risk factors, for example, age, tobacco use and obesity, as well as a shared inflammatory pathogenesis. The CV ris

Cardiovascular toxicity from therapies for light chain amyloidosis.

Amyloid light-chain (AL) amyloidosis is a hematological disorder characterized by abnormal proliferation of a plasma cell clone producing monoclonal free light chains that misfold and aggregate into insoluble fibrils in various tissues. Cardiac involvement is a common feature leading to restrictive cardiomyopathy and poor prognosis. Current first-line treatments aim at achieving hematological response by targeting the plasma cell clones, and these have been adapted from multiple myeloma therapy. Patients with AL amyloidosis often exhibit multiorgan involvement, making them susceptible to cance

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… Proteasome inhibitor-related cardiotoxicity: mechanisms. Diagnosis, and management. Curr Oncol Rep. (2020) 22(7):66. 10.1007/s11912-020-00931-w 48. Herrmann J. Adverse cardiac effects of cancer therapies: cardiotoxicity and arrhythmia. … Molecular mechanism involved in cyclophosphamide-induced cardiotoxicity: old drug with a new vision. Life Sci. (2019) 218:112–31. 10.1016/j.lfs.2018.12.018 66. Goldberg M, Antin J, Guinan E, Rappeport J. Cyclophosphamide cardiotoxicity: an analysis of dosing as a risk factor. …

Plitidepsin has a safe cardiac profile: a comprehensive analysis.

Plitidepsin is a cyclic depsipeptide of marine origin in clinical development in cancer patients. Previously, some depsipeptides have been linked to increased cardiac toxicity. Clinical databases were searched for cardiac adverse events (CAEs) that occurred in clinical trials with the single-agent plitidepsin. Demographic, clinical and pharmacological variables were explored by univariate and multivariate logistic regression analysis. Forty-six of 578 treated patients (8.0%) had at least one CAE (11 patients (1.9%) with plitidepsin-related CAEs), none with fatal outcome as a direct consequence

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… The incidence of cardiotoxicity related to oncological therapy depends on treatment-related factors (type of drug, cumulative dose and schedule of administration, combination of potentially cardiotoxic drugs, or association with mediastinal radiotherapy), but also on patient-related factors (age, presence … Ng R Better N Green MD Anticancer agents and cardiotoxicity Semin. Oncol 2006 33 2 14 16473642 10.1053/j.seminoncol.2005.11.001 …

Atrial Cardiomyopathy and Atrial Fibrillation in Cancer.

The number of patients with oncologic and cardiologic comorbidities is increasing. A growing number of evidence shows an inextricable link between cancer, atrial fibrillation, and atrial cardiomyopathy. Cancer itself and resultant inflammation, anticancer treatment, and other comorbidities lead to atrial remodeling and fibrosis, which increases the tendency to develop atrial cardiomyopathy and atrial fibrillation. The scarcity of current literature and ambiguous results make its relationship difficult to fully understand. In this review, we will summarize existing evidence of the relationships

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… The abnormality of these markers has been shown to be related to the cardiotoxicity and prognosis of cancer patients ( Table 2 ). LA enlargement and dysfunction may relate with higher risk of cardiotoxicity during therapy in breast cancer [ 33 , 34 ]. … The persistence of increased levels of NT-proBNP after the treatment may be helpful for the detection of patients with high risk of cardiotoxicity [ 47 ]. …

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals.

In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The

Cardiac Cachexia: Unaddressed Aspect in Cancer Patients.

Tumor-derived cachectic factors such as proinflammatory cytokines and neuromodulators not only affect skeletal muscle but also affect other organs, including the heart, in the form of cardiac muscle atrophy, fibrosis, and eventual cardiac dysfunction, resulting in poor quality of life and reduced survival. This article reviews the holistic approaches of existing diagnostic, pathophysiological, and multimodal therapeutic interventions targeting the molecular mechanisms that are responsible for cancer-induced cardiac cachexia. The major drivers of cardiac muscle wasting in cancer patients are au

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… Tamoxifen-induced cardiotoxicity was also assessed by documenting increasing trends in the cardiac-specific biochemical markers [ 59 ]. … Moreover, newer generation TKI are more cardiotoxic than the older generation ones. 8. …

Exploration of the Use of Natural Compounds in Combination with Chemotherapy Drugs for Tumor Treatment.

Currently, chemotherapy is the main treatment for tumors, but there are still problems such as unsatisfactory chemotherapy results, susceptibility to drug resistance, and serious adverse effects. Natural compounds have numerous pharmacological activities which are important sources of drug discovery for tumor treatment. The combination of chemotherapeutic drugs and natural compounds is gradually becoming an important strategy and development direction for tumor treatment. In this paper, we described the role of natural compounds in combination with chemotherapeutic drugs in synergizing, reduci

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… Cardiotoxicity Anthracycline antineoplastic agents are an important part of chemotherapeutic drugs and are widely used in hematologic malignancies and solid tumors, but the typical use of anthracycline antineoplastic agents is associated with cardiotoxicity, which seriously affects the progress of subsequent … Cardioprotective effect of silymarin nanoemulsion on 5-fluorouracil-induced cardiotoxicity in rats Arch. Pharm. 2022 355 e2200060 10.1002/ardp.202200060 35411625 133. Hu X. Li B. Li L. Li B. Luo J. Shen B. Asiatic Acid Protects against Doxorubicin-Induced Cardiotoxicity in Mice Oxidative Med. …

Cancer-Therapy-Related Cardiac Dysfunction: Latest Advances in Prevention and Treatment.

The increasing efficacy of cancer therapies has significantly improved survival rates, but it has also highlighted the prevalence of cancer-therapy-related cardiac dysfunction (CTRCD). This review provides a comprehensive overview of the identification, monitoring, and management of CTRCD, a condition resulting from several treatments, such as anthracyclines, HER2-targeted therapies, target therapies, and radiotherapy. The paper includes a discussion of the mechanisms of CTRCD associated with various cancer treatments. Early detection through serum biomarkers and advanced imaging techniques is

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… Epigenetics also plays a pivotal role in chemotherapy-related cardiotoxicity. Circulating methylated DNA from damaged myocytes has been proposed as a potential biomarker for cardiotoxicity. … Metabolic changes further contribute to cardiotoxicity risk. Asnani et al. observed reduced citric acid levels in HER2+ breast cancer patients who developed cardiotoxicity, with these reductions correlating with LVEF depression. …

Endothelial Function in Patients with Hematologic Malignancies Undergoing High-Dose Chemotherapy Followed by Hematopoietic Stem Cell Transplantation.

The aim of the study was to examine endothelial function in patients with hematological malignancies treated with high-dose chemotherapy followed by hematopoietic stem cell transplantation. The studies were conducted on 43 consecutive patients qualified for HSCT following high-dose chemotherapy based on the current standards. Then, due to exclusion criteria, a group of 38 patients were chosen for further investigations. Evaluation of endothelial function by means of flow-mediated dilatation (FMD) was conducted in patients with hematological malignancies before HSCT (test A) and after HSCT (tes

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… Until now, the detailed range of possible cardiovascular complications and potential cardiotoxic effects of the stem cell administration in individual groups of patients remains unknown. … Cardiotoxicity caused by chemotherapeutic regimens including peri-transplantation period is currently an important issue. Unfortunately, echocardiography fails to detect more subtle alterations in the heart [ 12 ]. …

Анализ факторов риска для серьезных сердечно-сосудистых событий у пациентов с мультиплексной миеломой.

ЦЕЛЬ: Определить факторы риска для серьезных кардиоваскулярных событий (MACE) у пациентов с мультиплексной миеломой (ММ) и оценить эффективность внешней стратификации на основе рискового счёта. МЕТОДЫ: В результате ретроспективного анализа 162 новых случаев мультиплексной миеломы, лечившихся в Университете Цзиньдао (2017-2023). Собранные данные включали демографические характеристики на начальном этапе, сопутствующие заболевания, лабораторные и эхокардиографические показатели, а также экспозицию на лечение. Серьезные кардиоваскулярные события ( Failure heart, острый коронарный синдром, злокач

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… Although cumulative dose data were incomplete in our retrospective dataset, the dose-dependent nature of anthracycline cardiotoxicity is well established, and the exposure signal persisted after adjustment. … Classification, prevalence, and outcomes of anticancer therapy-induced cardiotoxicity: the CARDIOTOX registry. Eur Heart J. (2020) 41(18):1720–9. 10.1093/eurheartj/ehaa006 20. Callander NS, Baljevic M, Adekola K, Anderson LD, Campagnaro E, Castillo JJ, et al. …

Acute and Chronic Cardiovascular Adverse Events in Patients with Acute Myeloid Leukemia: A Systematic Review.

Background/Objectives: Patients with acute myeloid leukemia (AML) have a higher propensity for adverse cardiovascular outcomes, primarily due to the toxic effects of chemotherapeutic agents. The purpose of this systematic review is to explore the association of acute myeloid leukemia treatment with adverse cardiovascular events. Methods: We systematically screened the literature for studies providing comparative data on cardiovascular toxicities in patients treated for acute myeloid leukemia. After the initial search, 3649 papers were screened and a final total number of 46 were included for t

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… AML and Cardiotoxicity AML is a common hematologic malignancy. Chemotherapeutic regimens that are used in patients with leukemia have potential cardiotoxic effects. … Timeline of Cardiotoxicity The potential cardiotoxic effects of chemotherapy may become apparent in different time intervals during the follow-up of AML patients. These effects are classified into three categories. …

Temporal trends in disease-specific causes of cardiovascular mortality amongst patients with cancer in the USA between 1999 and 2019.

AimsWe report disease-specific cardiovascular causes of mortality among cancer patients in the USA between 1999 and 2019, considering temporal trends by age, sex, and cancer site.Methods and resultsWe used the Multiple Cause of Death database, accessed through the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research resource. We included 629 308 decedents with cardiovascular disease (CVD) recorded as the primary cause of death and active malignancy listed as a contributing cause of death. We created disease-specific CVD categories and grouped cancers b

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… than those who were older, perhaps reflecting more intensive therapy choices in younger breast cancer patients with higher treatment doses or greater use of combination therapies, 21–23 which carry augmented risk of cardiotoxicity. … Anthracycline cardiotoxicity: prevalence, pathogenesis and treatment. Curr Cardiol Rev 2011;7:214–220. 31. Cardinale D, Colombo A, Bacchiani G, Tedeschi I, Meroni CA, Veglia Fet al. Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. …

Charting the Current Landscape and Future Prospects of Cancer Therapy-Related Cardiovascular Toxicity in Cancer Survivors: From Bench to Bedside.

Cardio-oncology represents an emerging interdisciplinary discipline focusing on optimizing oncologic efficacy while mitigating treatment-related cardiovascular complications. The advent of novel anticancer agents such as targeted therapies, immune checkpoint inhibitors, and endocrine therapies has transformed cancer care, significantly improving survival rates. Nevertheless, prolonged patient survivorship has unmasked clinically significant cardiovascular sequelae, termed cancer therapy-related cardiovascular toxicity (CTR-CVT), which manifests as acute manifestations during therapy and delaye

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… Efficacy of dexrazoxane in preventing anthracycline cardiotoxicity in breast cancer. JACC CardioOncol . 2019;1(1):68–79. doi: 10.1016/j.jaccao.2019.08.003 19. Kwok JC, Richardson DR. The cardioprotective effect of the iron chelator dexrazoxane (ICRF-187) on anthracycline-mediated cardiotoxicity. … Cardiotoxicity of cancer therapy. J Clin Oncol . 2005;23(30):7685–7696. doi: 10.1200/JCO.2005.08.789 26. Tan-Chiu E, Yothers G, Romond E, et al. …

Determining Risk Factors Associated with Cardiovascular Complications in Patients with Acute Leukemia: A Systematic Review.

BackgroundPatients with acute leukemia (AL) are at heightened risk of cardiovascular complications due to both disease-related and treatment-related factors. These complications include heart failure, arrhythmias, myocardial infarction, and thromboembolic events which may significantly impact morbidity and mortality.ObjectiveTo identify the risk factors contributing to cardiovascular complications in patients with acute leukemia.MethodsThis systematic review was conducted according to the PRISMA reporting guideline. Multiple databases including PubMed, Scopus, IEEE Xplore, the Cochrane Library

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… LV GLS was more sensitive than LVEF for early cardiotoxicity detection. … ACE inhibitors or beta-blockers may have prevented cardiotoxicity. …

Artificial intelligence-derived left ventricular strain in echocardiography in patients treated with chemotherapy.

Global longitudinal strain (GLS) is an echocardiographic measure to detect chemotherapy-related cardiovascular dysfunction. However, its limited availability and the needed expertise may restrict its generalization. Artificial intelligence (AI)-based GLS might overcome these challenges. Our aims are to explore the agreements between AI-based GLS and conventional GLS, and to assess whether the agreements were influenced by expertise levels, cardiac remodeling and cardiovascular diseases/risks. Echocardiographic images in the apical four-chamber view of left ventricle were retrospectively analyz

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… Ewer MS Ewer SM Cardiotoxicity of anticancer treatments Nat Rev Cardiol 2015 12 547 558 10.1038/nrcardio.2015.65 25962976 Ewer MS, Ewer SM (2015) Cardiotoxicity of anticancer treatments. Nat Rev Cardiol 12:547–558 25962976 10.1038/nrcardio.2015.65 4. … detection of subclinical anthracycline cardiotoxicity in breast cancer patients: a balance with feasibility. …

Chemotherapy-Induced Tissue Injury: An Insight into the Role of Extracellular Vesicles-Mediated Oxidative Stress Responses.

The short- and long-term side effects of chemotherapy limit the maximum therapeutic dose and impair quality of life of survivors. Injury to normal tissues, especially chemotherapy-induced cardiomyopathy, is an unintended outcome that presents devastating health impacts. Approximately half of the drugs approved by the Food and Drug Administration for cancer treatment are associated with the generation of reactive oxygen species, and Doxorubicin (Dox) is one of them. Dox undergoes redox cycling by involving its quinone structure in the production of superoxide free radicals, which are thought to

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… A histological study of endomyocardial biopsies from patients experiencing DOX-induced cardiotoxicity revealed extensive ER dilation [ 20 ], suggesting that ER stress is a major mechanism of DOX-induced cardiotoxicity. … Autophagy and mitophagy in the context of doxorubicin-induced cardiotoxicity Oncotarget 2017 8 46663 46680 10.18632/oncotarget.16944 28445146 PMC5542301 27. Dirks-Naylor A.J. …

Early diagnostic value of high-sensitivity cardiac troponin T for cancer treatment-related cardiac dysfunction: a meta-analysis.

Early diagnosis of cancer treatment-related cardiac dysfunction (CTRCD) is important as cancer therapy increases the risk of cardiac dysfunction. High-sensitivity cardiac troponin T (hs-cTnT) is a highly specific marker of myocardial injury. However, its diagnostic value for CTRCD has not been systematically evaluated. This meta-analysis aimed to evaluate whether hs-cTnT could be used as an early diagnostic biomarker for CTRCD. We systematically surveyed PubMed, Embase, Cochrane Library, and Web of Science databases for studies of hs-cTnT for the diagnosis of CTRCD before 1 April 2022. Patient

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… , mean (SD): 55 (2.0); cardiotoxicity, mean (SD): 57 (4.3) | 100 | 7 | No cardiotoxicity, mean (SD): 70 (1.0); cardiotoxicity, mean (SD): 73 (1.0) | No cardiotoxicity, mean (SD): 7 (1.7); cardiotoxicity, mean (SD): 5 (1.9) | 40 | 3 months | 10 | 4 | 0 | 0 | 36 Katsurada et al ., 19 2014 | Prospective … Cardiotoxic effects and myocardial injury: the search for a more precise definition of drug cardiotoxicity . Clin Chem Lab Med . 2020 ; 59 : 51 – 57 . 32845860 10.1515/cclm-2020-0566 33 Askin L , Tanriverdi O , Turkmen S . …

Cardio-oncology: conflicting priorities of anticancer treatment and cardiovascular outcome.

BackgroundThis article about the emerging field of cardio-oncology highlights typical side effects of oncological therapies in the cardiovascular system, cardiovascular complications of malignancies itself, and potential preventive or therapeutic modalities.MethodsWe performed a selective literature search in PubMed until September 2016.ResultsCardiovascular events in cancer patients can be frequently attributed to oncological therapies or to the underlying malignancy itself. Furthermore, many patients with cancer have pre-existing cardiovascular diseases that can be aggravated by the malignan

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… The dose-independent type of cardiotoxicity is usually not associated with structural damage of cardiomyocytes, thus, chemotherapy can often be resumed after a short pause or in mild forms be continued [ 13 , 14 ]. Table 1 Characteristics of type-1 and type-2-cardiotoxicity. … Fig. 2 Cardiac monitoring of patients during potentially cardiotoxic cancer therapy. *Reassessment with discontinuation of cardiotoxic therapy vs. dose reduction vs. change of chemotherapeutic drug vs. unmodified continuation of oncologic treatment. **Optional. …