Cancer Therapy-Related Cardiac Dysfunction of Nonanthracycline Chemotherapeutics

Janine A.M. Kamphuis, MD; Marijke Linschoten, MD; Maarten J. Cramer, MD, PhD; Eelke H. Gort, MD, PhD; Anna van Rhenen, MD, PhD; Folkert W. Asselbergs, MD, PhD; Pieter A. Doevendans, MD, PhD; Arco J. Teske, MD, PhD

JACC. CardioOncology (Dec 2019)

Cancer Therapy-Related Cardiac Dysfunction of Nonanthracycline Chemotherapeutics

Janine A.M. Kamphuis, MD,
Marijke Linschoten, MD,
Maarten J. Cramer, MD, PhD,
Eelke H. Gort, MD, PhD,
Anna van Rhenen, MD, PhD,
Folkert W. Asselbergs, MD, PhD,
Pieter A. Doevendans, MD, PhD,
Arco J. Teske, MD, PhD

Affiliations

Janine A.M. Kamphuis, MD: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
Marijke Linschoten, MD: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
Maarten J. Cramer, MD, PhD: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
Eelke H. Gort, MD, PhD: Department of Medical Oncology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
Anna van Rhenen, MD, PhD: Department of Haematology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
Folkert W. Asselbergs, MD, PhD: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom; Health Data Research UK and Institute of Health Informatics, University College London, London, United Kingdom
Pieter A. Doevendans, MD, PhD: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands; Netherlands Heart Institute, Utrecht, the Netherlands
Arco J. Teske, MD, PhD: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands; Address for correspondence: Dr. Arco J. Teske, University Medical Center Utrecht, E03.511, P.O. Box 85500, 3508 GA Utrecht, the Netherlands.

Journal volume & issue: Vol. 1, no. 2
pp. 280 – 290

Abstract

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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.

Published in JACC. CardioOncology

ISSN: 2666-0873 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jacc-cardiooncology

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