Cardiovascular considerations DURING cancer therapy🫀
The second of a 3 part
#JACCCardioOnc Expert Panel series exploring cardiovascular care before, during, & after cancer therapy.
Recommendations for
#CardioOncology care during cancer treatment:
Cardioprotection🛡️:
📍ACEI/ARB, beta-blockers, & statins may be considered to prevent ⬇️LVEF with anthracyclines
📍Consider dexrazoxane or liposomal doxorubicin for high cumulative anthracycline dose or LVEF <50%
📍Implement strategies to minimize cardiac radiation exposure
Surveillance🖥️:
📍Echo for anthracyclines & HER2-targeted therapies
📍Troponin & ECG for patients receiving ICIs
📍Prompt treatment & evaluation for high suspicion of ICI myocarditis
📍Blood pressure monitoring for VEGFi, BTKi, & ALKi therapies
📍Lipid monitoring for lorlatinib
Permissive cardiotoxicity⚖️:
📍Continue HER2-targeted therapy in selected patients with mild LV dysfunction, but need to evaluate risk & benefits
📍ACEi may be reasonable in patients with ⬆️ troponin during anthracycline therapy
📍Nitrates and/or calcium channel blockers can be considered to treat & rechallenge selected patients with 5-FU/capecitabine vasospasm, with close monitoring
Read more in
@JACCJournals:
jacc.org/doi/10.1016/j.jacca…