Management and research in cancer treatment-related cardiovascular toxicity: Challenges and perspectives.
Cardiovascular toxicity is a potentially serious complication that can result from the use of various cancer therapies and can impact the short- and long-term prognosis of treated patients as well as cancer survivors. In addition to their potential acute cardiovascular adverse events, new treatments can lead to late toxicity even after their completion because patients who survive longer generally have an increased exposure to the cancer therapies combined to standard cardiovascular risk factors. These complications expose the patient to the risk of cardiovascular morbi-mortality, which makes managing cardiovascular toxicity a significant challenge. Cardio-oncology programs offer the opportunity to improve cardiovascular monitoring, safety, and management through a better understanding of the pathogenesis of toxicity and interdisciplinary collaborations. In this review, we address new challenges, perspectives, and research priorities in cancer therapy-related cardiovascular toxicity to identify strategies that could improve the overall prognosis and survival of cancer patients. We also focus our discussion on the contribution of cardio-oncology in each step of the development and use of cancer therapies.
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France.
Jennifer
J
Cautela
Aix-Marseille University, Technological Advances for Genomics and Clinics (TAGC), UMR/INSERM 1090, France.
Nathalie
N
Lalevée
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France.
Chloé
C
Ammar
Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Cardiology, Saint-Antoine Hospital, France.
Stéphane
S
Ederhy
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France.
Michael
M
Peyrol
Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Sainte Catherine Institute, Department of Medical Oncology, Avignon, France.
Philippe
P
Debourdeau
Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Sainte Catherine Institute, Department of Medical Oncology, Avignon, France.
Daniel
D
Serin
Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Hôpital Saint Joseph, Department of Cardiology, Marseille, France.
Yvan
Y
Le Dolley
Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Hôpital Saint Joseph, Department of Cardiology, Marseille, France.
Nicolas
N
Michel
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France.
Morgane
M
Orabona
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France.
Jérémie
J
Barraud
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France.
Marc
M
Laine
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France; Aix-Marseille University, INSERM, UMRS 1076, France.
Laurent
L
Bonello
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France; Aix-Marseille University, INSERM, UMRS 1076, France.
Franck
F
Paganelli
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Multidisciplinary Oncology & Therapeutic Innovations Department, Assistance Publique - Hôpitaux de Marseille (AP-HM), Hôpital Nord, France.
Fabrice
F
Barlési
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Mediterranean university Cardio-Oncology center (MEDI-CO center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosafety Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), France. Electronic address: franck.thuny@gmail.com.
Franck
F
Thuny
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D035843:Biomedical Research / Q000379:methods; D066126:Cardiotoxicity / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002319:Cardiovascular System / Q000187:drug effects*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration; D011379:Prognosis; D018570:Risk Assessment
D000970:Antineoplastic Agents
Cancer therapy; Cardio-oncology; Cardiovascular toxicity; Heart failure; Prevention; Survivorship