Cardiovascular side effects of cancer therapies: a position statement from the Heart Failure Association of the European Society of Cardiology.

TY - JOUR

T1 - Cardiovascular side effects of cancer therapies: a position statement from the Heart Failure Association of the European Society of Cardiology.

AU - Eschenhagen, Thomas

AU - Force, Thomas

AU - Ewer, Michael S

AU - Keulenaer, de

AU - Gilles, W

AU - Suter, Thomas M

AU - Anker, Stefan D

AU - Avkiran, Metin

AU - de Azambuja, Evandro

AU - Balligand, Jean-Luc

AU - Brutsaert, Dirk L

AU - Hansen, Arne

AU - Hansen, Arne

AU - Heymans, Stephane

AU - Hill, Joseph A

AU - Hirsch, Emilio

AU - Hilfiker-Kleiner, Denise

AU - Janssens, Stefan

AU - de Jong, Steven

AU - Neubauer, Gitte

AU - Pieske, Burkert

AU - Ponikowski, Piotr

AU - Pirmohamed, Munir

AU - Rauchhaus, Mathias

AU - Sawyer, Douglas

AU - Sugden, Peter H

AU - Wojta, Johann

AU - Zannad, Faiez

AU - Shah, Ajay M

PY - 2011/1/1

Y1 - 2011/1/1

N2 - The reductions in mortality and morbidity being achieved among cancer patients with current therapies represent a major achievement. However, given their mechanisms of action, many anti-cancer agents may have significant potential for cardiovascular side effects, including the induction of heart failure. The magnitude of this problem remains unclear and is not readily apparent from current clinical trials of emerging targeted agents, which generally under-represent older patients and those with significant co-morbidities. The risk of adverse events may also increase when novel agents, which frequently modulate survival pathways, are used in combination with each other or with other conventional cytotoxic chemotherapeutics. The extent to which survival and growth pathways in the tumour cell (which we seek to inhibit) coincide with those in cardiovascular cells (which we seek to preserve) is an open question but one that will become ever more important with the development of new cancer therapies that target intracellular signalling pathways. It remains unclear whether potential cardiovascular problems can be predicted from analyses of such basic signalling mechanisms and what pre-clinical evaluation should be undertaken. The screening of patients, optimization of therapeutic schemes, monitoring of cardiovascular function during treatment, and the management of cardiovascular side effects are likely to become increasingly important in cancer patients. This paper summarizes the deliberations of a cross-disciplinary workshop organized by the Heart Failure Association of the European Society of Cardiology (held in Brussels in May 2009), which brought together clinicians working in cardiology and oncology and those involved in basic, translational, and pharmaceutical science.

AB - The reductions in mortality and morbidity being achieved among cancer patients with current therapies represent a major achievement. However, given their mechanisms of action, many anti-cancer agents may have significant potential for cardiovascular side effects, including the induction of heart failure. The magnitude of this problem remains unclear and is not readily apparent from current clinical trials of emerging targeted agents, which generally under-represent older patients and those with significant co-morbidities. The risk of adverse events may also increase when novel agents, which frequently modulate survival pathways, are used in combination with each other or with other conventional cytotoxic chemotherapeutics. The extent to which survival and growth pathways in the tumour cell (which we seek to inhibit) coincide with those in cardiovascular cells (which we seek to preserve) is an open question but one that will become ever more important with the development of new cancer therapies that target intracellular signalling pathways. It remains unclear whether potential cardiovascular problems can be predicted from analyses of such basic signalling mechanisms and what pre-clinical evaluation should be undertaken. The screening of patients, optimization of therapeutic schemes, monitoring of cardiovascular function during treatment, and the management of cardiovascular side effects are likely to become increasingly important in cancer patients. This paper summarizes the deliberations of a cross-disciplinary workshop organized by the Heart Failure Association of the European Society of Cardiology (held in Brussels in May 2009), which brought together clinicians working in cardiology and oncology and those involved in basic, translational, and pharmaceutical science.

KW - Anthracyclines

KW - Antibodies, Monoclonal

KW - Antibodies, Monoclonal, Humanized

KW - Antineoplastic Agents

KW - Cardiology

KW - Cardiotoxins

KW - Cardiovascular System

KW - Education

KW - Europe

KW - Heart Failure

KW - Humans

KW - Neoplasms

KW - Practice Guidelines as Topic

KW - Receptor, Epidermal Growth Factor

KW - Risk Factors

KW - Sirolimus

U2 - 10.1093/eurjhf/hfq213

DO - 10.1093/eurjhf/hfq213

M3 - SCORING: Journal article

C2 - 21169385

VL - 13

SP - 1

EP - 10

JO - EUR J HEART FAIL

JF - EUR J HEART FAIL

SN - 1388-9842

IS - 1

M1 - 1

ER -