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Oncology Drug Therapy: Cardiotoxicity and the Discipline of Cardio-oncology

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Cardiovascular Safety in Drug Development and Therapeutic Use

Abstract

The three preceding chapters, which comprise Part IV of this book, discussed topics falling within the domain of proarrhythmic cardiac safety. As we move into Part V, attention now broadens to other domains within the field of cardiovascular safety. This chapter addresses cardiotoxicity considerations in the therapeutic use of oncologic agents. The construct and employment of benefit–risk assessments have been discussed in several contexts in previous chapters. As we move into discussions related to the therapeutic use of drugs that have received marketing approval, the observation by Garattini (2010) that “drug authorization, prescription, and utilization are all based on benefit-risk assessment” provides an integrated perspective on this topic.

Treating physicians need to be thoroughly acquainted with the cardiotoxic effects of anti-cancer drugs so that they can diagnose them early on and avoid jeopardizing the overall success of treatment (Schlitt et al. 2014).

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References

  • Alexander J, Dainiak N, Berger HJ et al (1979) Serial assessment of doxorubicin cardiotoxicity with quantitative radionuclide angiocardiography. N Engl J Med 300:278–283

    Article  CAS  PubMed  Google Scholar 

  • ALLHAT Collaborative Research Group (2000) Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA 283:1967–75

    Article  Google Scholar 

  • Amini-Khoei H, Hosseini MJ, Momeny M, et al (2016) Morphine attenuated the cytotoxicity induced by arsenic trioxide in H9c2 cardiomyocytes. Biol Trace Elem Res [Epub ahead of print]

    Google Scholar 

  • Blaes AH, Rehman A, Vock DM et al (2015) Utility of high-sensitivity cardiac troponin T in patients receiving anthracycline chemotherapy. Vasc Health Risk Manag 11:591–594

    Article  PubMed  PubMed Central  Google Scholar 

  • Cardinale D, Bacchiani G, Beggiato M, Colombo A, Cipolla CM (2013) Strategies to prevent and treat cardiovascular risk in cancer patients. Semin Oncol 40:186–198

    Article  CAS  PubMed  Google Scholar 

  • Cardinale D, Colombo A, Bacchiani G et al (2015) Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. Circulation 131:1891–1998

    Article  CAS  Google Scholar 

  • Christenson ES, James T, Agrawal V, Park BH (2015) Use of biomarkers for the assessment of chemotherapy-induced cardiac toxicity. Clin Biochem 48:223–235

    Article  CAS  PubMed  Google Scholar 

  • Christian JB, Finkle JK, Ky B et al (2012) Cardiac imaging approaches to evaluate drug-induced myocardial dysfunction. Am Heart J 164:846–855

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Curigliano G, Cardinale D, Suter T, ESMO Guidelines Working Group et al (2012) Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines. Ann Oncol 23(Suppl 7):155–166

    Google Scholar 

  • Curigliano G, Cardinale D, Dent S et al (2016) Cardiotoxicity of anticancer treatments: epidemiology, detection, and management. CA Cancer J Clin [Epub ahead of print]

    Google Scholar 

  • Doxorubicin Package Insert. Available at: https://www.doxil.com/shared/product/doxil/doxil-prescribing-information.pdf Accessed 8 Mar 2016

  • Ewer MS, Lenihan DJ (2008) Left ventricular ejection fraction and cardiotoxicity: is our ear really to the ground? J Clin Oncol 26:1201–1203

    Article  PubMed  Google Scholar 

  • Ferri N, Siegl P, Corsini A et al (2013) Drug attrition during pre-clinical and clinical development: understanding and managing drug-induced cardiotoxicity. Pharmacol Ther 138:470–484

    Article  CAS  PubMed  Google Scholar 

  • Florea VG, Anand IS (2012) Biomarkers. Heart Fail Clin 8:207–24

    Article  PubMed  Google Scholar 

  • Garattini S (2010) Evaluation of benefit-risk. Pharmacoeconomics 28:981–986

    Article  PubMed  Google Scholar 

  • Gottdiener JS, Bednarz J, Devereux R, American Society of Echocardiography et al (2004) American Society of Echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr 17:1086–1119

    Google Scholar 

  • Grossman E, Messerli FH (2012) Drug-induced hypertension: an unappreciated cause of secondary hypertension. Am J Med 125:14–22

    Article  CAS  PubMed  Google Scholar 

  • Heart Outcomes Prevention Evaluation Study Investigators (2000) Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 355:253–259

    Article  Google Scholar 

  • Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342

    Article  CAS  PubMed  Google Scholar 

  • Kozloff M, Yood MU, Berlin J et al (2009) Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study. Oncologist 14:862–870

    Article  CAS  PubMed  Google Scholar 

  • Lenihan DJ, Cardinale DM (2012) Late cardiac effects of cancer treatment. J Clin Oncol 30:3657–3664

    Article  PubMed  Google Scholar 

  • Lenihan DJ, Cardinale D, Cipolla CM (2010) The compelling need for a cardiology and oncology partnership and the birth of the International CardiOncology Society. Prog Cardiovasc Dis 53:88–93

    Article  PubMed  Google Scholar 

  • Lipshultz SE, Colan SD, Gelber RD et al (1991) Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. N Engl J Med 324:808–815

    Article  CAS  PubMed  Google Scholar 

  • Morrow DA, Cannon CP, Jesse RL et al (2007) National Academy Of Clinical Biochemistry Laboratory Medicine Practice Guidelines: clinical characteristics and utilization of biochemical markers in acute coronary syndromes. Circulation 115:e356–e375

    Article  PubMed  Google Scholar 

  • Newby LK, Rodriguez I, Finkle J et al (2011) Troponin measurements during drug development: considerations for monitoring and management of potential toxicity. Am Heart J 162:64–73

    Article  CAS  PubMed  Google Scholar 

  • O’Brien E, Turner JR (2013) Assessing blood pressure responses to noncardiovascular drugs: the beneficial role of ambulatory blood pressure monitoring. J Clin Hypertens (Greenwich) 15:55–62

    Article  Google Scholar 

  • Pennell DJ, Sechtem UP, Higgins CB et al (2004) Clinical indications for cardiovascular magnetic resonance (CMR): consensus panel report. Eur Heart J 25:1940–1965

    Article  PubMed  Google Scholar 

  • Pituskin E (2015) Primary results of the MANTICORE randomized, controlled trial. Paper presented at San Antonio Breast Cancer Symposium. Abstract S1-05, 9 December 2015

    Google Scholar 

  • Raschi E, Vasina V, Ursino MG et al (2010) Anticancer drugs and cardiotoxicity: insights and perspectives in the era of targeted therapy. Pharmacol Ther 125:196–218

    Article  CAS  PubMed  Google Scholar 

  • Robinson ES, Khankin EV, Karumanchi SA, Humphreys BD (2010) Hypertension induced by VEGF signaling pathway inhibition: mechanisms and potential use as a biomarker. Semin Nephrol 30:591–601

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rowland JH, Kent EE, Forsythe LP et al (2013) Cancer survivorship research in Europe and the United States: where have we been, where are we going, and what can we learn from each other? Cancer 119(Suppl 11):2094–2108

    Article  PubMed  PubMed Central  Google Scholar 

  • Rutkowski P, Stępniak J (2016) The safety of regorafenib for the treatment of gastrointestinal stromal tumors. Expert Opin Drug Saf 15:105–116

    Article  CAS  PubMed  Google Scholar 

  • Sager P, Heilbraun J, Turner JR et al (2013) Assessment of drug-induced increases in blood pressure during drug development: report from the Cardiac Safety Research Consortium. Am Heart J 165:477–488

    Article  PubMed  Google Scholar 

  • Schlitt A, Jordan K, Vordermark D et al (2014) Cardiotoxicity and oncological treatments. Dtsch Arztebl Int 111:161–168

    PubMed  PubMed Central  Google Scholar 

  • Seicean S, Seicean A, Alan N et al (2013) Cardioprotective effect of β-adrenoceptor blockade in patients with breast cancer undergoing chemotherapy: follow-up study of heart failure. Circ Heart Fail 6:420–426

    Article  CAS  PubMed  Google Scholar 

  • Small HY, Montezano AC, Rios FJ et al (2014) Hypertension due to antiangiogenic cancer therapy with vascular endothelial growth factor inhibitors: understanding and managing a new syndrome. Can J Cardiol 30:534–543

    Article  PubMed  Google Scholar 

  • Smith TA, Phyu SM, Akabuogu EU (2016) Effects of administered cardioprotective drugs on treatment response of breast cancer cells. Anticancer Res 36:87–93

    Article  CAS  PubMed  Google Scholar 

  • Steingart RM, Bakris GL, Chen HX et al (2012) Management of cardiac toxicity in patients receiving vascular endothelial growth factor signaling pathway inhibitors. Am Heart J 163:156–163

    Article  CAS  PubMed  Google Scholar 

  • Steinherz LJ, Steinherz PG, Tan CTC, Heller G, Murphy ML (1991) Cardiac toxicity 4 to 20 years after completing anthracycline therapy. JAMA 266:1672–1677

    Article  CAS  PubMed  Google Scholar 

  • Suter TM, Ewer MS (2013) Cancer drugs and the heart: importance and management. Eur Heart J 34:1102–1111

    Article  CAS  PubMed  Google Scholar 

  • Tashakori Beheshti A, Mostafavi Toroghi H, Hosseini G et al (2016) Carvedilol administration can prevent doxorubicin-induced cardiotoxicity: a double-blind randomized trial. Cardiology 134:47–53

    Article  CAS  PubMed  Google Scholar 

  • Thiene G, Corrado D, Basso C (2008) Revisiting definition and classification of cardiomyopathies in the era of molecular medicine. Eur Heart J 29:144–146

    Article  PubMed  Google Scholar 

  • Turner JR, Durham TA (2009) Integrated cardiac safety: assessment methodologies for noncardiac drugs in discovery, development, and postmarketing surveillance. Wiley, Hoboken

    Google Scholar 

  • Turner JR, Panicker GK, Karnad DR et al (2014) Cardiovascular safety monitoring during oncology drug development and therapy. Am J Ther 21:512–522

    Article  PubMed  Google Scholar 

  • Wallace KB, Hausner E, Herman E et al (2004) Serum troponins as biomarkers of drug-induced cardiac toxicity. Toxicol Pathol 32:106–121

    Article  CAS  PubMed  Google Scholar 

  • Wu S, Chen JJ, Kudelka A et al (2008) Incidence and risk of hypertension with sorafenib in patients with cancer: a systematic review and meta-analysis. Lancet Oncol 9:117–123

    Article  CAS  PubMed  Google Scholar 

  • Yancy CW, Jessup M, Bozlurt B et al (2013) 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62:e147–e239

    Article  PubMed  Google Scholar 

  • Yusuf SW, Ilias-Khan NA, Durand JB (2011) Chemotherapy-induced cardiomyopathy. Expert Rev Cardiovasc Ther 9:231–243

    Article  CAS  PubMed  Google Scholar 

  • Zhu X, Stergiopoulos K, Wu S (2009) Risk of hypertension and renal dysfunction with an angiogenesis inhibitor sunitinib: systematic review and meta-analysis. Acta Oncol 48:9–17

    Article  CAS  PubMed  Google Scholar 

Further Reading

  • Akman T, Erbas O, Akman L, Yilmaz AU (2014) Prevention of pazopanib-induced prolonged cardiac repolarization and proarrhythmic effects. Arq Bras Cardiol 103:403–409

    PubMed  PubMed Central  Google Scholar 

  • Angsutararux P, Luanpitpong S, Issaragrisil S (2015) Chemotherapy-induced cardiotoxicity: overview of the roles of oxidative stress. Oxid Med Cell Longev 2015:795602

    Article  PubMed  PubMed Central  Google Scholar 

  • Aroldi F, Prochilo T, Bonini E, Zaniboni A (2016) QT prolongation and anticancer drugs: is it a cardiologist’s worry? The oncologist’s point of view. Rev Recent Clin Trials [Epub ahead of print]

    Google Scholar 

  • Barac A, Lynce F, Smith KL et al (2016) Cardiac function in BRCA1/2 mutation carriers with history of breast cancer treated with anthracyclines. Breast Cancer Res Treat 155:285–293

    Article  CAS  PubMed  Google Scholar 

  • Barac A, Murtagh G, Carver JR et al (2015) Cardiovascular health of patients with cancer and cancer survivors: a roadmap to the next level. J Am Coll Cardiol 65:2739–2746

    Article  PubMed  PubMed Central  Google Scholar 

  • Bellinger AM, Arteaga CL, Force T et al (2015) Cardio-oncology: how new targeted cancer therapies and precision medicine can inform cardiovascular discovery. Circulation 132:2248–2258

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bhave M, Akhter N, Rosen ST (2014) Cardiovascular toxicity of biologic agents for cancer therapy. Oncology (Williston Park) 28:482–490

    Google Scholar 

  • Blaes AH, Rehman A, Vock DM et al (2015) Utility of high-sensitivity cardiac troponin T in patients receiving anthracycline chemotherapy. Vasc Health Risk Manag 11:591–594

    Article  PubMed  PubMed Central  Google Scholar 

  • Bloom MW, Hamo CE, Cardinale D et al (2016) Cancer therapy-related cardiac dysfunction and heart failure: Part 1: definitions, pathophysiology, risk factors, and imaging. Circ Heart Fail 9:e002661

    Article  PubMed  PubMed Central  Google Scholar 

  • Blumenthal GM, Cortazar P, Zhang JJ et al (2012) FDA approval summary: sunitinib for the treatment of progressive well-differentiated locally advanced or metastatic pancreatic neuroendocrine tumors. Oncologist 17:1108–1113

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bodai BI, Tuso P (2015) Breast cancer survivorship: a comprehensive review of long-term medical issues and lifestyle recommendations. Perm J 19:48–79

    Article  PubMed  PubMed Central  Google Scholar 

  • Braddock M, Heilbraun J, Mendzelevski B (2013) Cardiovascular safety and hemodynamic considerations in oncology drug development - webinar highlights October 10th 2012. Expert Opin Drug Saf 12:783–791

    Article  CAS  PubMed  Google Scholar 

  • Cardinale D, Colombo A, Lamantia G et al (2008) Cardio-oncology: a new medical issue. Ecancermedicalscience 2:126

    CAS  PubMed  PubMed Central  Google Scholar 

  • Cardinale D, Colombo A, Lamantia G et al (2010) Anthracycline-induced cardiomyopathy: clinical relevance and response to pharmacologic therapy. J Am Coll Cardiol 55:213–220

    Article  CAS  PubMed  Google Scholar 

  • Chaudry M, Banchs J, Chavez-MacGregor M (2016) Anthracycline or trastuzumab-related cardiotoxicity: do we have a predictive biomarker? Biomark Med 10:315–328

    Google Scholar 

  • Chen CL (2015) Cardiovascular prevention in the cancer survivor. Curr Atheroscler Rep 17:484

    Article  PubMed  CAS  Google Scholar 

  • Chow EJ, Chen Y, Kremer LC et al (2015) Individual prediction of heart failure among childhood cancer survivors. J Clin Oncol 33:394–402

    Article  PubMed  Google Scholar 

  • Christensen JF, Bandak M, Campbell A, Jones LW, Højman P (2015) Treatment-related cardiovascular late effects and exercise training countermeasures in testicular germ cell cancer survivorship. Acta Oncol 54:592–599

    Article  PubMed  PubMed Central  Google Scholar 

  • Christenson ES, James T, Agrawal V, Park BH (2015) Use of biomarkers for the assessment of chemotherapy-induced cardiac toxicity. Clin Biochem 48:223–235

    Article  CAS  PubMed  Google Scholar 

  • Conway A, McCarthy AL, Lawrence P, Clark RA (2015) The prevention, detection and management of cancer treatment-induced cardiotoxicity: a meta-review. BMC Cancer 15:366

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Cummins M, Pavlakis N (2013) The use of targeted therapies in pancreatic neuroendocrine tumours: patient assessment, treatment administration, and management of adverse events. Ther Adv Med Oncol 5:286–300

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • D’Amore C, Gargiulo P, Paolillo S et al (2014) Nuclear imaging in detection and monitoring of cardiotoxicity. World J Radiol 6:486–492

    Article  PubMed  PubMed Central  Google Scholar 

  • de Vries Schultink AH, Suleiman AA, Schellens JH, Beijnen JH, Huitema AD (2016) Pharmacodynamic modeling of adverse effects of anti-cancer drug treatment. Eur J Clin Pharmacol 72:645–653

    Google Scholar 

  • Denlinger CS, Carlson RW, Are M et al (2014) Survivorship: introduction and definition. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 12:34–45

    Article  PubMed  PubMed Central  Google Scholar 

  • Ederhy S, Izzedine H, Massard C et al (2011) Cardiac side effects of molecular targeted therapies: towards a better dialogue between oncologists and cardiologists. Crit Rev Oncol Hematol 80:369–379

    Article  PubMed  Google Scholar 

  • Ewer MS, Ewer SM (2015) Cardiotoxicity of anticancer treatments. Nat Rev Cardiol 12:547–558

    Article  CAS  PubMed  Google Scholar 

  • Ewer M, Gianni L, Pane F et al (2014) Report on the international colloquium on cardio-oncology (Rome, 12-14 march 2014). Ecancermedicalscience 8:433

    PubMed  PubMed Central  Google Scholar 

  • Eschenhagen T, Force T, Ewer MS et al (2011) Cardiovascular side effects of cancer therapies: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 13:1–10

    Article  PubMed  Google Scholar 

  • Faruque LI, Lin M, Battistella M et al (2014) Systematic review of the risk of adverse outcomes associated with vascular endothelial growth factor inhibitors for the treatment of cancer. PLoS One 9:e101145

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Fradley MG, Moslehi J (2015) QT prolongation and oncology drug development. Card Electrophysiol Clin 7:341–355

    Article  PubMed  Google Scholar 

  • Ghatalia P, Je Y, Kaymakcalan MD, Sonpavde G, Choueiri TK (2015) QTc interval prolongation with vascular endothelial growth factor receptor tyrosine kinase inhibitors. Br J Cancer 112:296–305

    Article  CAS  PubMed  Google Scholar 

  • Ghigo A, Li M, Hirsch E (2016) New signal transduction paradigms in anthracycline-induced cardiotoxicity. Biochim Biophys Acta 1863:1916–1925

    Google Scholar 

  • Gulati G, Zhang KW, Scherrer-Crosbie M, Ky B (2014) Cancer and cardiovascular disease: the use of novel echocardiography measures to predict subsequent cardiotoxicity in breast cancer treated with anthracyclines and trastuzumab. Curr Heart Fail Rep 11:366–373

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hahn VS, Lenihan DJ, Ky B (2014) Cancer therapy-induced cardiotoxicity: basic mechanisms and potential cardioprotective therapies. J Am Heart Assoc 3:e000665

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Hamo CE, Bloom MW (2015) Getting to the heart of the matter: an overview of cardiac toxicity related to cancer therapy. Clin Med Insights Cardiol 9(Suppl 2):47–51

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hamo CE, Bloom MW, Cardinale D et al (2016) Cancer therapy-related cardiac dysfunction and heart failure: Part 2: prevention, treatment, guidelines, and future directions. Circ Heart Fail 9:e002843

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Herman E, Knapton A, Zhang J et al (2014) The utility of serum biomarkers to detect myocardial alterations induced by imatinib in rats. Pharmacol Res Perspect 2:e00015

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Herrmann J, Lerman A, Sandhu NP et al (2014) Evaluation and management of patients with heart disease and cancer: cardio-oncology. Mayo Clin Proc 89:1287–1306

    Article  PubMed  PubMed Central  Google Scholar 

  • Iliescu CA, Grines CL, Herrmann J et al (2016) SCAI expert consensus statement: evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (endorsed by the cardiological society of India, and Sociedad Latino Americana de Cardiologia Intervencionista). Catheter Cardiovasc Interv 87:E202–E223

    Google Scholar 

  • Jang S, Zheng C, Tsai HT et al (2016) Cardiovascular toxicity after antiangiogenic therapy in persons older than 65 years with advanced renal cell carcinoma. Cancer 122:124–130

    Article  CAS  PubMed  Google Scholar 

  • Jensen BC, McLeod HL (2013) Pharmacogenomics as a risk mitigation strategy for chemotherapeutic cardiotoxicity. Pharmacogenomics 14:205–213

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kaneko S, Tham EB, Haykowsky MJ et al (2016) Impaired left ventricular reserve in childhood cancer survivors treated with anthracycline therapy. Pediatr Blood Cancer 63:1086–1090

    Google Scholar 

  • Kirkham AA, Davis MK (2015) Exercise prevention of cardiovascular disease in breast cancer survivors. J Oncol 2015:917606

    Article  PubMed  PubMed Central  Google Scholar 

  • Kleiman R, Litwin J, Morganroth J (2016) Benefits of centralized ECG reading in clinical oncology studies. Ther Innov Regul Sci 50:123–129

    Article  Google Scholar 

  • Kloth JS, Pagani A, Verboom MC et al (2015) Incidence and relevance of QTc-interval prolongation caused by tyrosine kinase inhibitors. Br J Cancer 112:1011–1016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Korzeniowska K, Jankowski J, Cieślewicz A, Jabłecka A (2015) Current approach for detection of sub-clinical left ventricular dysfunction associated with chemotherapy. Pharmacol Rep 67:1098–1102

    Article  CAS  PubMed  Google Scholar 

  • Lamore SD, Kamendi HW, Scott CW, Dragan YP, Peters MF (2013) Cellular impedance assays for predictive preclinical drug screening of kinase inhibitor cardiovascular toxicity. Toxicol Sci 135:402–413

    Article  CAS  PubMed  Google Scholar 

  • Lancellotti P, Anker SD, Donal E et al (2015) EACVI/HFA Cardiac Oncology Toxicity Registry in breast cancer patients: rationale, study design, and methodology (EACVI/HFA COT Registry): EURObservational Research Program of the European Society of Cardiology. Eur Heart J Cardiovasc Imaging 16:466–470

    Article  PubMed  Google Scholar 

  • Lankhorst S, Kappers MH, van Esch JH, Danser AH, van den Meiracker AH (2013) Mechanism of hypertension and proteinuria during angiogenesis inhibition: evolving role of endothelin-1. J Hypertens 31:444–454

    Article  CAS  PubMed  Google Scholar 

  • Lankhorst S, Baelde HJ, Kappers MH et al (2015) Greater sensitivity of blood pressure than renal toxicity to tyrosine kinase receptor inhibition with sunitinib. Hypertension 66:543–549

    Article  CAS  PubMed  Google Scholar 

  • Lankhorst S, Kappers MH, van Esch JH et al (2014) Treatment of hypertension and renal injury induced by the angiogenesis inhibitor sunitinib: preclinical study. Hypertension 64:1282–1289

    Article  CAS  PubMed  Google Scholar 

  • Le DL, Cao H, Yang LX (2014) Cardiotoxicity of molecular-targeted drug therapy. Anticancer Res 34:3243–3249

    CAS  PubMed  Google Scholar 

  • Lenihan DJ (2014) Reversibility of effectively treated chemotherapy-related heart failure: raising our awareness and a call to action for cardiology. J Card Fail 20:159–160

    Article  PubMed  Google Scholar 

  • Lenihan DJ, Kowey PR (2013) Overview and management of cardiac adverse events associated with tyrosine kinase inhibitors. Oncologist 18:900–908

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lenihan DJ, Westcott G (2015) Cardio-oncology: a tremendous opportunity to improve patient care. Future Oncol 11:2007–2010

    Article  CAS  PubMed  Google Scholar 

  • Lenihan DJ, Cardinale DM (2012) Late cardiac effects of cancer treatment. J Clin Oncol 30:3657–3664

    Article  PubMed  Google Scholar 

  • Lenihan DJ, Oliva S, Chow EJ, Cardinale D (2013) Cardiac toxicity in cancer survivors. Cancer 119(Suppl 11):2131–2142

    Article  PubMed  Google Scholar 

  • Lipshultz SE, Franco VI, Miller TL, Colan SD, Sallan SE (2015) Cardiovascular disease in adult survivors of childhood cancer. Annu Rev Med 66:161–176

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Madan R, Benson R, Sharma DN, Julka PK, Rath GK (2015) Radiation induced heart disease: pathogenesis, management and review literature. J Egypt Natl Canc Inst 27:187–193

    Article  CAS  PubMed  Google Scholar 

  • Maharsy W, Aries A, Mansour O, Komati H, Nemer M (2014) Ageing is a risk factor in imatinib mesylate cardiotoxicity. Eur J Heart Fail 16:367–376

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mallarkey G, Mangoni AA (2015) Targeting precision medicine toxicity: recent developments. Ther Adv Drug Saf 6:4–14

    Article  PubMed  PubMed Central  Google Scholar 

  • Mantarro S, Rossi M, Bonifazi M et al (2016) Risk of severe cardiotoxicity following treatment with trastuzumab: a meta-analysis of randomized and cohort studies of 29,000 women with breast cancer. Intern Emerg Med 11:123–140

    Article  PubMed  Google Scholar 

  • Marmagkiolis K, Finch W, Tsitlakidou D et al (2016) Radiation toxicity to the cardiovascular system. Curr Oncol Rep 18:15

    Article  PubMed  CAS  Google Scholar 

  • McCabe MS, Bhatia S, Oeffinger KC et al (2013) American Society of Clinical Oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol 31:631–640

    Article  PubMed  PubMed Central  Google Scholar 

  • Molinaro M, Ameri P, Marone G et al (2015) Recent advances on pathophysiology, diagnostic and therapeutic insights in cardiac dysfunction induced by antineoplastic drugs. Biomed Res Int 2015:138–148

    Article  CAS  Google Scholar 

  • Mozdzanowska D, Woźniewski M (2015) Radiotherapy and anthracyclines: cardiovascular toxicity. Contemp Oncol (Pozn) 19:93–97

    CAS  Google Scholar 

  • Naumann D, Rusius V, Margiotta C et al (2013) Factors predicting trastuzumab-related cardiotoxicity in a real-world population of women with HER2+ breast cancer. Anticancer Res 33:1717–1720

    CAS  PubMed  Google Scholar 

  • Nekhlyudov L, Aziz NM, Lerro C, Virgo KS (2014) Oncologists’ and primary care physicians’ awareness of late and long-term effects of chemotherapy: implications for care of the growing population of survivors. J Oncol Pract 10:e29–e36

    Article  PubMed  Google Scholar 

  • Nekhlyudov L, Wenger N (2014) Institute of medicine recommendations for improving the quality of cancer care: what do they mean for the general internist? J Gen Intern Med 29:1404–1409

    Article  PubMed  PubMed Central  Google Scholar 

  • Nguyen KL, Alrezk R, Mansourian PG et al (2015) The crossroads of geriatric cardiology and cardio-oncology. Curr Geriatr Rep 4:327–337

    Article  PubMed  PubMed Central  Google Scholar 

  • Niraula S, Seruga B, Ocana A et al (2012) The price we pay for progress: a meta-analysis of harms of newly approved anticancer drugs. J Clin Oncol 30:3012–3019

    Article  PubMed  Google Scholar 

  • O’Hare M, Sharma A, Murphy K, Mookadam F, Lee H (2015) Cardio-oncology Part I: chemotherapy and cardiovascular toxicity. Expert Rev Cardiovasc Ther 13:511–518

    Article  PubMed  CAS  Google Scholar 

  • O’Hare M, Murphy K, Mookadam F, Sharma A, Lee H (2015) Cardio-oncology Part II: the monitoring, prevention, detection and treatment of chemotherapeutic cardiac toxicity. Expert Rev Cardiovasc Ther 13:519–527

    Article  PubMed  CAS  Google Scholar 

  • Onitilo AA, Engel JM, Stankowski RV (2014) Cardiovascular toxicity associated with adjuvant trastuzumab therapy: prevalence, patient characteristics, and risk factors. Ther Adv Drug Saf 5:154–166

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Pituskin E, Haykowsky M, Mackey JR et al (2011) Rationale and design of the Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research Trial (MANTICORE 101–Breast): a randomized, placebo-controlled trial to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer using cardiac MRI. BMC Cancer 11:318

    Article  PubMed  PubMed Central  Google Scholar 

  • Pizzino F, Vizzari G, Qamar R et al (2015) Multimodality imaging in cardio-oncology. J Oncol 2015:263950

    Article  PubMed  PubMed Central  Google Scholar 

  • Poulin F, Thavendiranathan P (2015) Cardiotoxicity due to chemotherapy: role of cardiac imaging. Curr Cardiol Rep 17:564

    Article  PubMed  Google Scholar 

  • Rosa GM, Gigli L, Tagliasacchi MI et al (2016) Update on cardiotoxicity of anti-cancer treatments. Eur J Clin Invest 46:264–284

    Article  PubMed  Google Scholar 

  • Roth GJ, Binder R, Colbatzky F et al (2015) Nintedanib: from discovery to the clinic. J Med Chem 58:1053–1063

    Article  CAS  PubMed  Google Scholar 

  • Runowicz CD, Leach CR, Henry NL et al (2016) American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol 34:611–635

    Article  CAS  PubMed  Google Scholar 

  • Sager PT, Balser B, Wolfson J et al (2015) Electrocardiographic effects of class 1 selective histone deacetylase inhibitor romidepsin. Cancer Med 4:1178–1185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schindler M, Spycher BD, Ammann RA, Swiss Paediatric Oncology Group (SPOG) et al (2016) Cause-specific long-term mortality in survivors of childhood cancer in Switzerland: a population based study. Int J Cancer 139:322–333

    Google Scholar 

  • Schover LR, van der Kaaij M, van Dorst E et al (2014) Sexual dysfunction and infertility as late effects of cancer treatment. EJC Suppl 12:41–53

    Article  PubMed  PubMed Central  Google Scholar 

  • Shah RR, Morganroth J (2015) Update on cardiovascular safety of tyrosine kinase inhibitors: with a special focus on QT interval, left ventricular dysfunction and overall risk/benefit. Drug Saf 38:693–710

    Article  CAS  PubMed  Google Scholar 

  • Skinner M, Philp K, Lengel D et al (2014) The contribution of VEGF signalling to fostamatinib-induced blood pressure elevation. Br J Pharmacol 171:2308–2320

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Small HY, Montezano AC, Rios FJ, Savoia C, Touyz RM (2014) Hypertension due to antiangiogenic cancer therapy with vascular endothelial growth factor inhibitors: understanding and managing a new syndrome. Can J Cardiol 30:534–543

    Article  PubMed  Google Scholar 

  • Srikanthan A, Ethier JL, Ocana A et al (2015) Cardiovascular toxicity of multi-tyrosine kinase inhibitors in advanced solid tumors: a population-based observational study. PLoS One 10:e0122735

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Stevens PL, Lenihan DJ (2015) Cardiotoxicity due to chemotherapy: the role of biomarkers. Curr Cardiol Rep 17:603

    Article  PubMed  Google Scholar 

  • Todaro MC, Oreto L, Qamar R et al (2013) Cardioncology: state of the heart. Int J Cardiol 168:680–687

    Article  PubMed  Google Scholar 

  • Valachis A, Nilsson C (2015) Cardiac risk in the treatment of breast cancer: assessment and management. Breast Cancer (Dove Med Press) 7:21–35

    CAS  Google Scholar 

  • Valle JW, Faivre S, Hubner RA, Grande E, Raymond E (2014) Practical management of sunitinib toxicities in the treatment of pancreatic neuroendocrine tumors. Cancer Treat Rev 40:1230–1238

    Article  CAS  PubMed  Google Scholar 

  • Varga ZV, Ferdinandy P, Liaudet L, Pacher P (2015) Drug-induced mitochondrial dysfunction and cardiotoxicity. Am J Physiol Heart Circ Physiol 309:H1453–H1467

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Venkatakrishnan K, Friberg LE, Ouellet D et al (2015) Optimizing oncology therapeutics through quantitative translational and clinical pharmacology: challenges and opportunities. Clin Pharmacol Ther 97:37–54

    Article  CAS  PubMed  Google Scholar 

  • Vijayvergia N, Denlinger CS (2015) Lifestyle factors in cancer survivorship: where we are and where we are headed. Pers Med 5:243–263

    Article  Google Scholar 

  • Wickramasinghe CD, Nguyen KL, Watson KE, Vorobiof G, Yang EH (2016) Concepts in cardio-oncology: definitions, mechanisms, diagnosis and treatment strategies of cancer therapy-induced cardiotoxicity. Future Oncol 12:855–870

    Article  CAS  PubMed  Google Scholar 

  • Wiegers SE (2015) Cardio-oncology and echocardiography: partners in improving patient care. J Am Soc Echocardiogr 28:A15

    Article  PubMed  Google Scholar 

  • Yamazaki S (2013) Translational pharmacokinetic-pharmacodynamic modeling from nonclinical to clinical development: a case study of anticancer drug, crizotinib. AAPS J 15:354–366

    Article  PubMed  Google Scholar 

  • Yeboa DN, Evans SB (2016) Contemporary breast radiotherapy and cardiac toxicity. Semin Radiat Oncol 26:71–78

    Article  PubMed  Google Scholar 

  • Yu AF, Ky B (2016) Roadmap for biomarkers of cancer therapy cardiotoxicity. Heart 102:425–430

    Article  CAS  PubMed  Google Scholar 

  • Xie Y, Collins WJ, Audeh MW et al (2015) Breast cancer survivorship and cardiovascular disease: emerging approaches in cardio-oncology. Curr Treat Options Cardiovasc Med 17:60

    Article  PubMed  Google Scholar 

  • Xue J, Jiang Z, Qi F et al (2014) Risk of trastuzumab-related cardiotoxicity in early breast cancer patients: a prospective observational study. J Breast Cancer 17:363–369

    Article  PubMed  PubMed Central  Google Scholar 

  • Zagar TM, Cardinale DM, Marks LB (2016) Breast cancer therapy-associated cardiovascular disease. Nat Rev Clin Oncol 13:172–184

    Article  CAS  PubMed  Google Scholar 

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Turner, J.R., Karnad, D.R., Kothari, S. (2017). Oncology Drug Therapy: Cardiotoxicity and the Discipline of Cardio-oncology. In: Cardiovascular Safety in Drug Development and Therapeutic Use. Adis, Cham. https://doi.org/10.1007/978-3-319-40347-2_10

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