ESMO E-Learning: Cardiotoxicity in Oncology Practice

Learning Objectives

  1. To provide an update on cardiotoxicity in cancer patients
  2. To provide an overview of cardiovascular risk assessment, screening and monitoring of cardiac function during cancer treatments
  3. To provide an update on management strategies of chemotherapy-, targeted agents- or radiotherapy-induced cardiac toxicity
Title Duration Content CME Points CME Test
Cardiotoxicity in Oncology Practice 45 min. 43 slides 1 Take Test
Evandro De Azambuja
Evandro de Azambuja
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Advances in cancer treatments have improved patients’ outcomes, with many new molecules targeting different pathways being tested in patients with cancer. However, there is an increase in cardiac toxicities, which may dramatically affect patient’s quality of life. Therefore, cardiotoxicity has emerged as a common problem in oncology practice today.

Cardiac events can be at early or late onset. Anthracyclines cause irreversible damage and should be avoided in patients at high cardiac risk. Trastuzumab-associated cardiac events generally happen during treatment and are mostly reversible.

Thorough cardiac risk assessment should take place prior to any cancer treatment. Prompt diagnosis and treatment are required to avoid bad prognosis of heart failure. Hypertension should be treated to avoid treatment interruptions and life threatening conditions. Late valvular diseases should be considered in patients previously exposed to radiotherapy.

This E-Learning module provides an excellent overview of anticancer- treatment-related myocardial dysfunction and heart failure, coronary artery disease, systemic hypertension, thrombotic disease and QT-prolongation. However, due to time constraint, this module will not discuss arrhythmias, myocardial infarction and valvular disease in cancer patients.

Besides providing a magnitude of each of the above associated problems with particular treatment modality as well as with a class of anticancer agents, the author provides practical advice for diagnosis and management of cardiotoxicity in cancer patients. The module is also illustrated by cardiotoxicity findings from clinical trials in oncology.

This module is an excellent introduction to the newly emerged discipline of cardio-oncology. A close collaboration between oncologists and cardiologists is fundamental in terms of cardiovascular risk assessment and prevention, screening and monitoring of cardiac function during cancer treatment, which should take into account costs, feasibility, outcomes and management of pre-existing cardiac disease to promote the most effective cancer therapy, and active management of chemotherapy-, targeted agents- or radiotherapy-induced cardiac toxicity.

Last update: 03 March 2017

The author has reported honoraria and travel grants from Roche; travel grants from GSK. Research grants to his institution from Roche.