Register
Forgot your password?

Early prevention of cardio- toxicity in cancer patients: focus on medical therapy

Authors: Akildzhonov F.R., Buziashvili Yu.I., Asymbekova E.U., Tugeeva E.F., Alimov V.P.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

For correspondence:  Sign in or register.

Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2021-15-3-322-331

For citation: Akildzhonov F.R., Buziashvili Yu.I., Asymbekova E.U., Tugeeva E.F., Alimov V.P. Early prevention of cardiotoxicity in cancer patients: focus on medical therapy. Creative Cardiology. 2021; 15 (3): 322–31 (in Russ.). DOI: 10.24022/1997-3187-2021-15-3-322-331

Received / Accepted:  26.04.2021 / 24.08.2021

Keywords: cardiotoxicity anthracycline dexrazoxane

Download
Full text:  

 

Abstract

Over the past few decades, cancer treatment has made significant progress in improving the quality of life and survival of cancer patients. Cancer mortality has dropped significantly thanks to the development of early screening programs, improved diagnostic algorithms, and more effective treatment options, including targeted anti-cancer drugs. At the moment, more and more attention are paid to cardiotoxicity, which develops against the background of antitumor treatment. Internationally published guidelines for this category of patients do not fully cover all problems, and there is no standardized classification system for determining cardiotoxicity. Future research is expected to identify the precise molecular and genetic mechanisms involved in cardiotoxicity, allowing the development of new targets for targeted anticancer therapy. This review presents the current data on the early prevention of chemotherapy-induced cardiotoxicity.

References

  1. Mathur P., Sathishkumar K., Chaturvedi M., Das P., Sudarshan K.L., Santhappan S. et al. Cancer statistics, 2020: report from national cancer registry programme, India. JCO Glob. Oncol. 2020; 6: 1063–75. DOI: 10.1200/GO.20.00122
  2. Zamorano J., Lancellotti P., Rodriguez Muñoz D., Aboyans V., Asteggiano R., Galderisi M. et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: the Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology. Eur. Heart J. 2016; 37 (36): 2768–801. DOI: 10.1093/eurheartj/ehw211
  3. Чазова И.Е., Тюляндин С.А., Виценя М.В., Панченко Е.П., Федоткина Ю.А., Полтавская М.Г. и др. Руководство по диагностике, профилактике и лечению сердечно-сосудистых осложнений противоопухолевой терапии. Части VI–VII. Системные гипертензии. 2018; 15 (1): 6–20. DOI: 10.26442/2075-082Х_15.1.6-20 [Chazova I.E., Tyulyandin S.A., Vitsenya M.V., Panchenko E.P., Fedotkina Yu.A., Poltavskaya M.G. et al. Clinical manual for diagnosis, prevention and treatment of cardiovascular complications of cancer therapy. Parts VI–VII. Systemic Hypertension. 2018; 15 (1): 6–20 (in Russ.). DOI: 10.26442/2075-082X_15.1.6-20
  4. Schwartz C., Fajardo L., Coen V., Constine L. Radiation-associated cardiovascular disease: manifestations and management. Semin. Radiat. Oncol. 2003; 13 (3): 346–56. DOI: 10.1016/S1053- 4296(03)00026-2
  5. Plana J., Galderisi M., Barac A. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr. 2014; 27 (9): 911–39. DOI: 10.1016/j.echo.2014.07.012
  6. Cardinale D., Cipolla C. Chemotherapy-induced cardiotoxicity: importance of early detection. Expert. Rev. Cardiovasc. Ther. 2016; 14 (12): 1297–9. DOI: 10.1080/14779072.2016.1239528
  7. Pavo N., Raderer M., Hülsmann M. Cardiovascular biomarkers in patients with cancer and their association with all-cause mortality. Heart. 2015; 101 (23): 1874–80. DOI: 10.1136/heartjnl-2015-307848
  8. De Vito P. Atrial natriuretic peptide: an old hormone or a new cytokine? Peptides. 2014; 58: 108–16. DOI: 10.1016/j.peptides.2014.06.011
  9. Ezekowitz J., O'Meara E., McDonald M., Abrams H., Chan M., Ducharme A. et al. 2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure. Can. J. Cardiol. 2017; 33 (11): 1342–433. DOI: 10.1016/j.cjca.2017.08.022
  10. Puzanov I., Diab A., Abdallah K., Bingham C., Brogdon C., Dadu R. et al. Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group. J. Immunother. Cancer. 2017; 5 (1): 95. DOI: 10.1186/s40425-017-0300-z
  11. Henriksen P. Anthracycline cardiotoxicity: an update on mechanisms, monitoring and prevention. Heart. 2018; 104 (12): 971–7. DOI: 10.1136/heartjnl-2017-312103
  12. Brignardello-Petersen R., Bonner A., Alexander P., Siemieniuk R., Furukawa T., Rochwerg B. et al. Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis. J. Clin. Epidemiol. 2018; 93: 36–44. DOI: 10.1016/j.jclinepi.2017.10.005
  13. Sniderman A.D., Thanassoulis G., Wilkins J.T., Furberg C.D., Pencina M. Sick individuals and sick populations by geoffrey rose: cardiovascular prevention updated. J. Am. Heart Assoc. 2018; 7 (19): e010049. DOI: 10.1161/JAHA.118.010049
  14. Avila M., Siqueira S., Ferreira S., Bocchi E. Prevention and treatment of chemotherapy-induced cardiotoxicity. Methodist Debakey Cardiovasc. J. 2019; 15 (4): 267–73. DOI: 10.14797/mdcj-15-4-267
  15. Mackey J., Clemons M., Côté M., Delgado D., Dent S., Paterson A. et al. Cardiac management during adjuvant trastuzumab therapy: recommendations of the Canadian Trastuzumab Working Group. Curr. Oncol. 2008; 15 (1): 24–35. DOI: 10.3747/co.2008.199
  16. Ananthan K., Lyon A. The role of biomarkers in cardio-oncology. J. Cardiovasc. Transl. Res. 2020; 13 (3): 431–50. DOI: 10.1007/s12265-020-10042-3
  17. McGowan J., Chung R., Maulik A., Piotrowska I., Walker J., Yellon D. Anthracycline chemotherapy and cardiotoxicity. Cardiovasc. Drugs Ther. 2017; 31 (1): 63–75. DOI: 10.1007/s10557-016-6711-0
  18. Chang H., Moudgil R., Scarabelli T., Okwuosa T.M., Yeh E. Cardiovascular complications of cancer therapy: best practices in diagnosis, prevention, and management: Part 1. J. Am. Coll. Cardiol. 2017; 70 (20): 2536–551. DOI: 10.1016/j.jacc.2017.09.1096
  19. Salehi B., Selamoglu Z., Mileski K. Liposomal cytarabine as cancer therapy: from chemistry to medicine. Biomolecules. 2019; 9 (12): 773. DOI: 10.3390/biom9120773
  20. Ishihara A., Hatakeyama S., Suzuki J., Amano Y., Sasahara T., Toshima M., Morisawa Y. Histological evidence for the cardiac safety of high-dose pegylated liposomal doxorubicin in a patient with HIVassociated Kaposi sarcoma: a case report and literature review. BMC Infect. Dis. 2019; 19 (1): 848. DOI: 10.1186/s12879-019-4500-7
  21. Florenzano F., Salman P. Carvedilol for anthracycline cardiomyopathy prevention. J. Am. Coll. Cardiol. 2007; 49 (21): 2142–3. DOI: 10.1016/j.jacc.2007.03.016
  22. Seicean S., Seicean A., Alan N., Plana J., Budd G., Marwick T. Cardioprotective effect of β-adrenoceptor blockade in patients with breast cancer undergoing chemotherapy: follow-up study of heart failure. Circ. Heart Fail. 2013; 6 (3): 420–6. DOI: 10.1161/CIRCHEARTFAILURE.112.000055
  23. Lyu Y., Kerrigan J., Lin C., Azarova A., Tsai Y., Ban Y., Liu L. Topoisomerase II beta mediated DNA double-strand breaks: implications in doxorubicin cardiotoxicity and prevention by dexrazoxane. Cancer. Res. 2007; 67 (18): 8839–46. DOI: 10.1158/0008-5472.CAN-07-1649
  24. Jiang J., Mohan N., Endo Y., Shen Y., Wu W. Type IIB DNA topoisomerase is downregulated by trastuzumab and doxorubicin to synergize cardiotoxicity. Oncotarget. 2017; 9 (5): 6095–108. DOI: 10.18632/oncotarget.23543
  25. Cardinale D., Iacopo F., Cipolla C. Cardiotoxicity of anthracyclines. Front. Cardiovasc. Med. 2020; 7: 26. DOI: 10.3389/fcvm.2020.00026
  26. Kalay N., Basar E., Ozdogru I., Er O., Cetinkaya Y., Dogan A. et al. Protective effects of carvedilol against anthracycline-induced cardiomyopathy. J. Am. Coll. Cardiol. 2006; 48 (11): 2258–62. DOI: 10.1016/j.jacc.2006.07.052
  27. Avila M., Ayub-Ferreira S., Wanderley M., Jr., Cruz F., Brandão S., Rigaud V. et al. Carvedilol for Prevention of chemotherapy-related cardiotoxicity: the CECCY trial. J. Am. Coll. Cardiol. 2018; 71 (20): 2281–90. DOI: 10.1016/j.jacc.2018.02.049
  28. Mukai Y., Yoshida T., Nakaike R., Mukai N., Iwato K., Kyo T., Kaseda S. Five cases of anthracycline-induced cardiomyopathy effectively treated with carvedilol. Intern. Med. 2004; 43 (11): 1087–8. DOI: 10.2169/internalmedicine.43.1087
  29. Nabati M., Janbabai G., Baghyari S., Esmaili K., Yazdani J. Cardioprotective effects of carvedilol in inhibiting doxorubicin-induced cardiotoxicity. J. Cardiovasc. Pharmacol. 2017; 69 (5): 279–85. DOI: 10.1097/FJC.0000000000000470
  30. Gulati G., Heck S., Ree A., Hoffmann P., SchulzMenger J., Fagerland M. et al. Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): a 2×2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprolol. Eur. Heart J. 2016; 37 (21): 1671–80. DOI: 10.1093/eurheartj/ehw022
  31. Curigliano G., Cardinale D., Dent S., Criscitiello C., Aseyev O., Lenihan D., Cipolla C. Cardiotoxicity of anticancer treatments: Epidemiology, detection, and management. CA Cancer J. Clin. 2016; 66 (4): 309–25. DOI: 10.3322/caac.21341
  32. Bosch X., Esteve J., Sitges M., Caralt T., Domènech A., Ortiz J. et al. Prevention of chemotherapy-induced left ventricular dysfunction with enalapril and carvedilol: rationale and design of the OVERCOME trial. J. Card. Fail. 2011; 17 (8): 643–8. DOI: 10.1016/j.cardfail.2011.03.008
  33. Ayuna A., Abidin N. The role of neurohormonal blockers in the primary prevention of acute-, early-, and late-onset anthracycline-induced cardiotoxicity. Egypt. Heart J. 2020; 72 (1): 59. DOI: 10.1186/s43044-020-00090-0
  34. Cadeddu C., Piras A., Mantovani G., Deidda M., Dessì M., Madeddu C. et al. Protective effects of the angiotensin II receptor blocker telmisartan on epirubicin-induced inflammation, oxidative stress, and early ventricular impairment. Am. Heart J. 2010; 160 (3): 487.e1–7. DOI: 10.1016/j.ahj.2010.05.037
  35. Cardinale D., Ciceri F., Latini R., Grazia Franzosi M., Sandri M., Civelli M. et al. Anthracyclineinduced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial. Eur. J. Cancer. 2018; 94: 126–37. DOI: 10.1016/j.ejca.2018.02.005
  36. Pituskin E., Mackey J., Koshman J., Jassal D., Pitz M., Haykowsky M. et al. Multidisciplinary approach to novel therapies in cardio-oncology research (MANTICORE 101-Breast): a randomized trial for the prevention of trastuzumab-associated cardiotoxicity. J. Clin. Oncol. 2017; 35 (8): 870–7. DOI: 10.1200/JCO.2016.68.7830
  37. Akpek M., Ozdogru I., Sahin O., Inanc M., Dogan A., Yazici C. et al. Protective effects of spironolactone against anthracycline-induced cardiomyopathy. Eur. J. Heart Fail. 2015; 17 (1): 81–9. DOI: 10.1002/ejhf.196
  38. Vaduganathan M., Hirji S., Qamar A., Bajaj N., Gupta A., Zaha V. et al. Efficacy of neurohormonal therapies in preventing cardiotoxicity in patients with cancer undergoing chemotherapy. JACC CardioOncol. 2019; 1 (1): 54–65. DOI: 10.1016/j.jaccao.2019.08.006
  39. Henninger C., Fritz G. Statins in anthracyclineinduced cardiotoxicity: Rac and Rho, and the heartbreakers. Cell. Death. Dis. 2017; 8 (1): e2564. DOI: 10.1038/cddis.2016.418
  40. Reichardt P., Tabone M., Mora J., Morland B., Jones R. Risk-benefit of dexrazoxane for preventing anthracycline-related cardiotoxicity: re-evaluating the European labeling. Future Oncol. 2018; 14 (25): 2663–76. DOI: 10.2217/fon-2018-0210
  41. Hensley M., Hagerty K., Kewalramani T., Green D., Meropol N., Wasserman T. et al. American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J. Clin. Oncol. 2009; 27 (1): 127–45. DOI: 10.1200/JCO.2008.17.2627

About Authors

  • Firdavsdzhon R. Akildzhonov, Resident Physician; ORCID
  • Yuriy I. Buziashvili, Dr. Med. Sci., Professor, Academician of RAS, Head of Department; ORCID
  • El’mira U. Asymbekova, Dr. Med. Sci., Leading Researcher; ORCID
  • El’vina F. Tugeeva, Dr. Med. Sci., Senior Researcher; ORCID
  • Victor P. Alimov, Cardiologist; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Sort by