Emerging cancer therapies and cardiovascular risk
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Emerging cancer therapies and cardiovascular risk Wendy Bottinor1,2 · Amar Parikh2 · Eiman Jahangir2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The cardiovascular (CV) toxicity profiles of traditional cancer therapies such as anthracyclines and radiation therapy are familiar to many cardiologists. With the development and widespread use of additional cancer therapeutics, CV toxicities related to these agents are becoming more common. Cardiovascular specialists are often integrated into the care team for individuals with cancer and knowledge of the CV toxicities of cancer therapeutics has become essential. In this review, we provide a clinically focused summary of the current data regarding CV toxicities of common cancer therapies and identify potential management strategies for the CV specialist. Keywords Cardio-oncology · Cardiovascular toxicity · Androgen deprivation therapy · Immune checkpoint inhibitors · Vascular endothelial growth factor inhibitors · Tyrosine kinase inhibitors · Proteasome inhibitors Abbreviations ADT Androgen deprivation therapy BP Blood pressure CML Chronic myeloid leukemia CTLA-4 Cytotoxic T-lymphocyte-associated antigen 4 CV Cardiovascular FDA Food and Drug Administration GnRH Gonadotropin releasing receptor hormone HTN Hypertension ICI Immune checkpoint inhibitors PD-1 Programmed death -1 PDL-1 Programmed death ligand- 1 PI Proteasome inhibitors TKI Tyrosine kinase inhibitors VEGFi Vascular endothelial growth factor inhibitors
* Wendy Bottinor [email protected] 1
Division of Cardiovascular Medicine, Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Gateway bldg. 1200 E Marshall St, Richmond, VA 23298, USA
Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
2
Highlights • Many cancer therapeutics are associated with potential
cardiovascular toxicities.
• This review discusses cardiovascular toxicities of com-
mon cancer therapies.
• Potential management strategies are also provided.
Introduction The cardiovascular (CV) toxicity profiles of traditional cancer therapies such as anthracyclines and radiation therapy are familiar to many cardiologists. With the development and widespread use of additional cancer therapeutics, CV toxicities related to these agents are becoming more common. Cardiovascular specialists are often integrated into the care team for individuals with cancer and knowledge of the CV toxicities of cancer therapeutics has become essential. In this review, we provide a clinically focused summary of the current data regarding CV toxicities of common cancer therapies and identify potential management strategies for the CV specialist.
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Immune checkpoint inhibitors Immune checkpoint inhibitors (ICIs) are a novel class of anti-cancer agents that first entered the market in 2011 with ipilimumab, a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor, for the trea
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