title: Practices in management of cancer treatment-related cardiovascular toxicity: A cardio-oncology survey.
abstract: BACKGROUND
  Cardiovascular toxicity has become a challenging issue during cancer therapy. Nonetheless, there is a lack of consensual guidelines for their management. We aimed to determine the current practices of oncologists regarding cardiovascular toxicity related to anthracyclines, trastuzumab and angiogenic inhibitors and to gather their opinions on the development of cardio-oncology programs.
  
  
  METHODS
  A cross-sectional declarative study was submitted to French oncologists in the form of an individual, structured questionnaire.
  
  
  RESULTS
  A total of 303 oncologists responded to the survey. Ninety-nine percent of oncologists prescribed cardiotoxic therapies, including anthracyclines (83%), trastuzumab (51%) and other angiogenic inhibitors (64%). The method adopted for managing cardiovascular toxicity was based on guidelines from expert oncology societies for only 35% of oncologists. None was aware of recommendations from expert cardiology societies. Prescription of pre-, peri- and post-therapy cardiovascular assessment was inconsistent and significantly less frequent for all classes of angiogenic inhibitors than for anthracyclines and trastuzumab (P<0.0001). Relative to pre-therapy assessment, post-therapy assessment was prescribed significantly less often for all cancer therapies (P<0.0001). Attitudes regarding the onset of left ventricular dysfunction were much more inconsistent when angiogenic inhibitors were involved. Additionally, the management of hypertension and QT prolongation was also inconsistent. Finally, 88% of oncologists supported projects of cardio-oncology programs development.
  
  
  CONCLUSIONS
  Practices of oncologists are disparate in the field of cardiovascular toxicity. This finding underlines the complexity of managing many different situations and the need for distribution of formal guidelines from oncology and cardiology expert societies. The development of personalized cardio-oncology programs seems essential.
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Jovenaux
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cautela
authors.affiliation: Aix-Marseille University, Department of Public Health, Research Unit EA 3279, France.
authors.forename: Noemie
authors.initials: N
authors.lastname: Resseguier
authors.affiliation: Assistance Publique - Hôpitaux de Marseille (AP-HM), ONCO-PACA-CORSE Oncology Regional Network, France.
authors.forename: Michele
authors.initials: M
authors.lastname: Pibarot
authors.affiliation: Assistance Publique - Hôpitaux de Marseille (AP-HM), ONCO-PACA-CORSE Oncology Regional Network, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Taouqi
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Orabona
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France.
authors.forename: Johan
authors.initials: J
authors.lastname: Pinto
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France.
authors.forename: Michael
authors.initials: M
authors.lastname: Peyrol
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Barraud
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France.
authors.forename: Marc
authors.initials: M
authors.lastname: Laine
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bonello
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France.
authors.forename: Franck
authors.initials: F
authors.lastname: Paganelli
authors.affiliation: Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France; Aix-Marseille University, Multidisciplinary Oncology & Therapeutic Innovations Department, Assistance Publique - Hôpitaux de Marseille (AP-HM), Hôpital Nord, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Barlesi
authors.affiliation: 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 Association for Research and Studies in Cardiology (MARS Cardio), France; Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France; Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP(2)), France. Electronic address: franck.thuny@gmail.com.
authors.forename: Franck
authors.initials: F
authors.lastname: Thuny
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D000072096:Cardiologists / Q000706:statistics & numerical data; D054715:Cardiotoxins / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology; D003430:Cross-Sectional Studies; D019468:Disease Management; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents; D054715:Cardiotoxins
keywords: Cancer therapy; Cardio-oncology; Cardiotoxicity; Heart failure; Prevention