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Cancer Therapy-Related Cardiac Dysfunction of Nonanthracycline Chemotherapeutics What Is the Evidence?

Kamphuis, JAM; Linschoten, M; Cramer, MJ; Gort, EH; van Rhenen, A; Asselbergs, FW; Doevendans, PA; (2019) Cancer Therapy-Related Cardiac Dysfunction of Nonanthracycline Chemotherapeutics What Is the Evidence? JACC: CardioOncology , 1 (2) pp. 280-290. 10.1016/j.jaccao.2019.09.007. Green open access

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Abstract

Cancer therapy–related cardiac dysfunction (CTRCD) is one of the most concerning cardiovascular side effects of cancer treatment. Important reviews within the field of cardio-oncology have described various agents to be associated with a high risk of CTRCD, including mitomycin C, ifosfamide, vincristine, cyclophosphamide, and clofarabine. The aim of this study was to provide insight into the data on which these incidence rates are based. We observed that the reported cardiotoxicity of mitomycin C and ifosfamide is based on studies in which most patients received anthracyclines, complicating the interpretation of their association with CTRCD. The high incidence of vincristine-induced cardiotoxicity is based on an incorrect interpretation of a single study. Incidence rates of clofarabine remain uncertain due to a lack of cardiac screening in clinical trials. The administration of high-dose cyclophosphamide (>1.5 g/m2/day) is associated with a high incidence of CTRCD. Based on our findings, a critical re-evaluation of the cardiotoxicity of these agents is warranted.

Type: Article
Title: Cancer Therapy-Related Cardiac Dysfunction of Nonanthracycline Chemotherapeutics What Is the Evidence?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jaccao.2019.09.007
Publisher version: http://dx.doi.org/10.1016/j.jaccao.2019.09.007
Language: English
Additional information: ª 2019 THE AUTHORS. PUBLISHED BY EL SEVIER ON BEHALF OF THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION. THIS IS AN OPEN ACCESS ARTICLE UNDER THE CC BY-NC-ND LICENSE ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ) .
Keywords: alkylating therapy, cardiomyopathy, heart failure, risk prediction
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10125426
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