BMJ Oncology,
Journal Year:
2023,
Volume and Issue:
2(1), P. e000090 - e000090
Published: Oct. 1, 2023
Advances
in
the
detection
and
treatment
of
cancer
have
translated
into
improved
survival
rates
a
growing
population
survivors.
These
include
those
living
with
individuals
free
disease
following
treatment.
Epidemiological
studies
demonstrate
that
survivors
are
at
an
increased
risk
cardiovascular
(CVD),
(CV)
mortality
overtaking
some
tumour
types.
Cancer
CVD
share
common
aetiological
factors,
for
example,
age,
tobacco
use
obesity,
as
well
shared
inflammatory
pathogenesis.
The
CV
risks
mediastinal
radiotherapy
chemotherapy,
first
observed
1970s
anthracyclines,
long
been
appreciated.
More
recently,
targeted
anticancer
therapeutics
(human
epidermal
growth
factor
receptor-2
therpies,
vascular
endothelial
inhibitors,
second/third-generation
BCR-ABL
multiple
myeloma
therapies
combination
RAF
MEK
inhibitors
particular)
immunotherapies
added
to
burden
treatment-related
toxicity.
Additionally,
therapy
may
indirectly
impact
on
health
by
decreasing
physical
activity,
increasing
weight
gain
accelerating
ageing
process.
Improving
overall
outcomes
considering
cardiological
prevention
management
survivorship
is
area
interest.
assessment
recommended
post-cancer
accordance
primary
guidelines.
European
Society
Cardiology
2022
guidelines
also
recommend
enhanced
surveillance
after
treatments
moderate
high
consequences.
aim
this
article
provide
overview
interconnections
between
CVD,
review
current
recommendations,
highlight
key
areas
ongoing
future
research.
Acta Oncologica,
Journal Year:
2025,
Volume and Issue:
64, P. 507 - 515
Published: April 13, 2025
Background:
BRAF/MEK
inhibitors
(BRAFi/MEKi)
improve
outcome
in
patients
with
BRAF-mutated
metastatic
melanoma
but
are
associated
cardiotoxicity,
leading
to
a
decline
left
ventricular
ejection
fraction
(LVEF).
This
study
aimed
evaluate
the
incidence,
timeline,
risk
factors,
and
reversibility
of
BRAFi/MEKi-induced
cardiotoxicity
real-world
setting.
Patients/materials
methods:
Patients
(n
=
170)
treated
Encorafenib/Binimetinib,
Vemurafenib/Cobimetinib,
or
Dabrafenib/Trametinib
at
Aarhus
Odense
University
Hospital,
Denmark,
from
2015
2023
were
included.
Cardiac
function
was
assessed
baseline
every
3
months
during
treatment
either
echocardiograms
multigated
acquisition
scans.
Cardiotoxicity
defined
as
reduction
LVEF
by
≥10
percentage
points
(pp)
an
<
50%
(Major
cardiotoxicity)
≥15
pp
remaining
>
(Minor
cardiotoxicity).
Results:
occurred
21%
patients,
14%
experiencing
major
cardiotoxicity.
The
mean
time
187
days,
92%
cases
occurring
within
first
year.
reversible
79%
following
dose
reduction,
pauses,
heart
failure
therapy,
continued
monitoring.
Baseline
atrial
fibrillation
(odds
ratio
13.67,
p
0.008)
identified
factor
for
Interpretation:
is
significant
manageable
complication,
often
timely
interventions.
Routine
monitoring
recommended.
majority
(92%)
cardiac
events
diagnosed
year
treatment,
which
might
warrant
discontinuation
routine
after
1
BRAFi/MEKi
treatment.
Clinical Kidney Journal,
Journal Year:
2023,
Volume and Issue:
16(12), P. 2336 - 2348
Published: Aug. 12, 2023
ABSTRACT
The
survival
rates
of
many
cancers
have
significantly
improved
due
to
recent
advancements
in
cancer
screening
and
therapeutics.
Although
better
outcomes
are
encouraging,
additional
health
challenges
surfaced,
the
utmost
which
is
burden
imposed
by
various
cardiovascular
renal
toxicities
anticancer
therapies.
To
improve
overall
outcome
patients
with
cancer,
it
essential
understand
manage
these
treatment-related
adverse
effects.
side
effects
antineoplastic
therapies
well-known
include
left
ventricular
dysfunction,
heart
failure,
myocardial
ischaemia,
QT
prolongation,
arrhythmia
hypertension.
Among
these,
hypertension
most
common
complication,
prevalent
about
40%
all
patients,
yet
frequently
overlooked
undertreated.
This
review
explores
intricate
connection
between
provides
distinct
approaches
diagnosing,
monitoring
managing
cancer.
We
also
outline
considerations
that
relevant
care
receiving
drugs
prohypertensive
potential.
British Journal of Pharmacology,
Journal Year:
2024,
Volume and Issue:
181(16), P. 2964 - 2990
Published: April 28, 2024
Abstract
Background
and
Purpose
Cancer
therapy‐related
cardiovascular
adverse
events
(CAEs)
in
presence
of
comorbidities,
are
the
spotlight
cardio‐oncology
guidelines.
Carfilzomib
(Cfz),
indicated
for
relapsed/refractory
multiple
myeloma
(MM),
presents
with
serious
CAEs.
MM
is
often
accompanied
co‐existing
comorbidities.
However,
Cfz
use
patients
cardiometabolic
syndrome
(CMS)
or
heart
failure
reduced
ejection
fraction
(HFrEF),
questionable.
Experimental
Approach
ApoE
−/−
C57BL6/J
male
mice
received
14
weeks
Western
Diet
(WD)
(CMS
models).
underwent
permanent
LAD
ligation
days
(early‐stage
HFrEF
model).
CMS‐
HFrEF‐burdened
two
consecutive
six
alternate
days.
Daily
metformin
atorvastatin
administrations
were
performed
additionally
to
Cfz,
as
prophylactic
interventions.
Mice
echocardiography,
while
proteasome
activity,
biochemical
molecular
analyses
conducted.
Key
Results
CMS
did
not
exacerbate
left
ventricular
(LV)
dysfunction,
whereas
led
metabolic
complications
both
models.
induced
autophagy
Ca
2+
homeostasis
dysregulation,
prevented
Cfz‐mediated
LV
dysfunction
deficits
CMS‐burdened
myocardium.
Early‐stage
depressed
function
increased
protein
phosphatase
2A
(PP2A)
activity.
further
myocardial
PP2A
inflammation
‐cycling
dysregulation.
Metformin
co‐administration
exerted
an
anti‐inflammatory
potential
on
myocardium
without
improving
function.
Conclusion
Implications
seem
Cfz‐induced
CAEs,
by
presenting
metabolism‐related
hidden
toxicity
PP2A‐related
cardiac
inflammation,
respectively.
retains
its
CMS,
mitigating
signalling
dysregulation
Current Oncology Reports,
Journal Year:
2023,
Volume and Issue:
25(10), P. 1107 - 1115
Published: Aug. 17, 2023
Abstract
Purpose
of
Review
To
provide
an
update
on
epidemiology,
risk
factors,
and
management
cardiac
arrhythmias
in
oncological
patients
within
the
context
new
European
Society
Cardiology
2022
guidelines
cardio-oncology.
Recent
Findings
One
side
effects
different
chemotherapeutics
is
their
pro-arrhythmic
activity.
Both
atrial
ventricular
may
be
induced
by
cancer
itself
or
anticancer
treatment.
studies
report
cardiotoxic
activity
such
promising
therapies
as
BRAF
MEK
inhibitors,
CAR-T
therapy.
Summary
Risk
factors
overlap
with
cardiovascular
diseases
but
there
are
some
groups
drugs
that
increase
cardiotoxicity.
It
crucial
to
aware
risks
associated
treatment
know
how
act
case
Frontiers in Oncology,
Journal Year:
2023,
Volume and Issue:
12
Published: Jan. 9, 2023
BRAF
V600E
represents
the
most
common
mutation
in
all
human
cancers.
Among
central
nervous
system
(CNS)
tumors,
is
mostly
found
pediatric
low-grade
gliomas
(pLGG,
~20%)
and,
less
frequently,
high-grade
(pHGG,
5-15%)
and
adult
glioblastomas
(GBM,
~5%).
The
integration
of
inhibitors
(BRAFi)
treatment
patients
with
brought
a
paradigm
shift
to
clinical
care.
However,
not
benefit
from
due
intrinsic
or
acquired
resistance
inhibition.
Defining
predictors
response,
as
well
developing
strategies
prevent
BRAFi
overcome
post-BRAFi
tumor
progression/rebound
growth
are
some
main
challenges
at
present
field.
In
this
review,
we
outline
current
achievements
limitations
inhibition
gliomas,
special
focus
on
potential
mechanisms
resistance.
We
discuss
future
directions
targeted
therapy
for
mutated
highlighting
how
insights
into
could
be
leveraged
improve
outcomes.
JACC CardioOncology,
Journal Year:
2022,
Volume and Issue:
4(4), P. 535 - 548
Published: Nov. 1, 2022
Trametinib
is
a
MEK1
(mitogen-activated
extracellular
signal-related
kinase
1)
inhibitor
used
in
the
treatment
of
BRAF
(rapid
accelerated
fibrosarcoma
B-type)–mutated
metastatic
melanoma.
Roughly
11%
patients
develop
cardiomyopathy
following
long-term
trametinib
exposure.
Although
described
clinically,
molecular
landscape
cardiotoxicity
has
not
been
characterized.
The
aim
this
study
was
to
test
hypothesis
that
promotes
widespread
transcriptomic
and
cellular
changes
consistent
with
oxidative
stress
impairs
cardiac
function.
Mice
were
treated
(1
mg/kg/d).
Echocardiography
performed
pre-
post-treatment.
Gross,
histopathologic,
biochemical
assessments
probe
for
changes.
Human
organoids
as
an
vitro
measurement
recovery.
Long-term
administration
associated
significant
reductions
survival
left
ventricular
ejection
fraction.
Histologic
analyses
heart
revealed
myocardial
vacuolization
calcification
28%
animals.
Bulk
RNA
sequencing
identified
435
differentially
expressed
genes
116
differential
signaling
pathways
treatment.
Upstream
gene
analysis
predicted
interleukin-6
regulator
17
relevant
genes,
suggestive
PI3K/AKT
JAK/STAT
activation,
which
subsequently
validated.
hearts
displayed
elevated
markers
stress,
myofibrillar
degeneration,
11-fold
down-regulation
apelin
receptor,
connexin-43
mislocalization.
To
confirm
direct
cardiotoxic
effects
trametinib,
human
6
days,
followed
by
6-day
media-only
Trametinib-treated
exhibited
diameter
contractility,
partial
recovery
removal
These
data
describe
pathologic
observed
cardiotoxicity,
supporting
exploration
drug
holidays
alternative
pharmacologic
strategies
disease
prevention.
Pharmaceuticals,
Journal Year:
2023,
Volume and Issue:
16(10), P. 1441 - 1441
Published: Oct. 11, 2023
Cardiotoxicity
is
a
well-known
adverse
effect
of
cancer-related
therapy
that
has
significant
influence
on
patient
outcomes
and
quality
life.
The
use
antineoplastic
drugs
to
treat
colorectal
cancers
(CRCs)
associated
with
number
undesirable
side
effects
including
cardiac
complications.
For
both
sexes,
CRC
ranks
second
accounts
for
four
out
every
ten
cancer
deaths.
According
the
reports,
almost
39%
patients
who
underwent
first-line
chemotherapy
suffered
cardiovascular
impairment.
Although
5-fluorouracil
still
backbone
regimen
colorectal,
gastric,
breast
cancers,
cardiotoxicity
caused
by
might
affect
anywhere
from
1.5%
18%
patients.
precise
mechanisms
underlying
treatment
are
complex
may
involve
modulation
various
signaling
pathways
crucial
maintaining
health
TKI
ErbB2
or
NRG-1,
VEGF,
PDGF,
BRAF/Ras/Raf/MEK/ERK,
PI3/ERK/AMPK/mTOR
pathway,
resulting
in
oxidative
stress,
mitochondrial
dysfunction,
inflammation,
apoptosis,
ultimately
damaging
tissue.
Thus,
identification
management
drug
while
minimizing
negative
impact
have
become
increasingly
important.
purpose
this
review
catalog
potential
cardiotoxicities
anticancer
targeted
used
as
well
strategies
focused
early
diagnosing,
prevention,
therapy.
International Journal of Molecular Sciences,
Journal Year:
2022,
Volume and Issue:
23(22), P. 14121 - 14121
Published: Nov. 15, 2022
Myocardial
protection
against
ischemia/reperfusion
injury
(IRI)
is
mediated
by
various
ligands,
activating
different
cellular
signaling
cascades.
These
include
classical
cytosolic
mediators
such
as
cyclic-GMP
(c-GMP),
kinases
Phosphatydilinositol-3-
(PI3K),
Protein
Kinase
B
(Akt),
Mitogen-Activated-Protein-
(MAPK)
and
AMP-activated
(AMPK)
kinases,
transcription
factors
signal
transducer
activator
of
3
(STAT3)
bioactive
molecules
vascular
endothelial
growth
factor
(VEGF).
Most
the
aforementioned
constitute
targets
anticancer
therapy;
they
are
also
involved
in
carcinogenesis,
most
current
anti-neoplastic
drugs
lead
to
concomitant
weakening
or
even
complete
abrogation
myocardial
cell
tolerance
ischemic
oxidative
stress.
Furthermore,
many
may
directly
induce
cardiotoxicity
via
their
pharmacological
effects,
indirectly
cardiovascular
side
effects.
The
combination
direct
drug
cardiotoxicity,
indirect
effects
neutralization
cardioprotective
defense
mechanisms
heart
prolonged
cancer
treatment
long-term
ventricular
dysfunction,
clinically
manifested
failure.
We
present
a
narrative
review
three
therapeutic
interventions,
namely
VEGF,
proteasome
Immune
Checkpoint
inhibitors,
having
opposing
on
same
intracellular
cascades
thereby
affecting
heart.
Moreover,
we
herein
comment
guidelines
for
managing
clinical
setting
role
confounders
cardiotoxicity.
