Abstract 749P
Background
PARP-inhibitors target pathogenic BRCA mutations and homologous recombination deficiency, representing a novel therapeutic approach in patients with this specific alteration, offering longer survival. However, their use in clinical practice has revealed a number of important cardiovascular side effects which can decrease patients' quality of life. This has been little researched, and the information we have is scarce.
Methods
We conducted an observational retropective study selecting patients treated with PARP-inhibitors between 2018 and 2021 in our institution, and analyzed their cardiovascular risk factors (CVRF). The aim of this study was to assess the incidence of cardiovascular events in this population.
Results
A total of 44 patients were analyzed. Data regarding demographic characteristics, CVRF and oncological information are shown in the table. When we analyzed cardiovascular events the results were as follows: the most frequent events were hypertension (20.5%) and palpitations (18.6%), most of them requiring cardiologic assessment and treatment with beta-blockers (16.3%) or antihypertensive drugs. 9.3% of the patients presented an ECG alteration and only 4.6% echocardiographic abnormalities. Two patients required hospital admission, because of an acute coronary síndrome and a pulmonary embolism. There were no congestive heart failure episodes related to PARP-inhibitors treatment. No patient had to stop treatment due to cardiotoxicity and there were no deaths related with cardiological events. 25% of the patients were referred to the cardiologist in order to optimize treatment and continued periodic reviews. Table: 749P
| Sex | Males: 4.7% Females: 95.3% |
| Median age | 55.0 |
| Hypertension | 11.6% |
| Diabetes | 7.0% |
| Hypercholesterolemia | 16.3% |
| Smoking habit | Non-smoker 46.5% Smoker 14.0% Former smoker 39.5% |
| History of coronary syndrome | 4.7% |
| Valvular disease | 2.3% |
| Arrhythmia | 7.0% |
| Anticoagulant/Antiplatelet treatment | 14% |
| Familiar history of heart disease | 4.7% |
| Type of tumor | Ovarian cancer: 93% Prostate cancer: 4.7% Breast cancer: 2.3% |
| Stage | I: 6.9% II: 6.9% III: 53.6% IV: 32.6% |
| Previous cardiotoxic treatments | Cisplatin: 4.7% Anthracyclines: 55.8% Antiangiogenic: 39.5% HER2 targeted therapy: 4.7% Thoracic radiotherapy: 7% |
| PARP-inhibitor | Olaparib: 46.5% Niraparib: 53.5% |
| Median duration of treatment (months) | 10.0 (1.0 - 53.0) |
Conclusions
Almost half of the patients in our study experienced some kind of cardiac event. Prospective studies with cardiovascular comprehensive follow-up protocols are needed. Due to the increased use of these drugs, it’s important to highlight the role of the cardiologist in order to optimize treatment, improve patients' symptoms and carry out a multidisciplinary approach.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.