Cardiac Effects of Cancer Therapy

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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Cardiac Effects of Cancer Therapy

Haoyi Zheng, Boris Kobrinsky, Stuart Katz and James L. Speyer

Summary of Key Points

Incidence

Cardiomyopathy/Chronic Heart Failure

• Anthracyclines: cardiomyopathy/chronic heart failure occurs in 5% to 20% of patients receiving cumulative doxorubicin (more than 450 mg/m²); the incidence is higher in children

• Other antineoplastics (e.g., mitoxantrone and cyclophosphamide): the incidence of cardiomyopathy/chronic heart failure is less than 2%

• Trastuzumab (not common as a single agent; increased risk with anthracycline)

• Radiation therapy: cardiomyopathy/chronic heart failure is common 5 to 20 years after use of a single anteroposterior port

QT Prolongation

• Arsenic trioxide (a black box warning from the U.S. Food and Drug Administration [FDA])

• Vandetanib (a black box warning from the FDA)

• Nilotinib (a black box warning from the FDA)

• Vemurafenib

Myocardial Ischemia

• Radiation therapy

• 5-Fluorouracil: 1% to 4.5% with infusion schedules

• Capecitabine

Edema

• Docetaxel, interleukins, interferons, tumor necrosis factor, cytokines, granulocyte-macrophage colony-stimulating factor, monoclonal antibody (CD20)

• All-trans retinoic acid

Hypertension

• Bevacizumab

Hypotension

• Interleukins

• Tumor necrosis factor

• Granulocyte-macrophage colony-stimulating factor

Pericardial Disease

• Radiation therapy: effusions in 6% to 30% of patients receiving radiation therapy directed at the chest; constriction in 2% of patients receiving radiation therapy directed at the chest with current techniques

• Cardiac tamponade

• Endocardial fibrosis

Etiology of Complications

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