TY - JOUR
T1 - Practices in management of cancer treatment-related cardiovascular toxicity
T2 - A cardio-oncology survey
AU - Jovenaux, Ludovic
AU - Cautela, Jennifer
AU - Resseguier, Noemie
AU - Pibarot, Michele
AU - Taouqi, Myriam
AU - Orabona, Morgane
AU - Pinto, Johan
AU - Peyrol, Michael
AU - Barraud, Jeremie
AU - Laine, Marc
AU - Bonello, Laurent
AU - Paganelli, Franck
AU - Barlesi, Fabrice
AU - Thuny, Franck
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/8/15
Y1 - 2017/8/15
N2 - 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.
AB - 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.
KW - Cancer therapy
KW - Cardio-oncology
KW - Cardiotoxicity
KW - Heart failure
KW - Prevention
UR - http://www.scopus.com/inward/record.url?scp=85016451508&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.02.154
DO - 10.1016/j.ijcard.2017.02.154
M3 - Article
C2 - 28365180
AN - SCOPUS:85016451508
SN - 0167-5273
VL - 241
SP - 387
EP - 392
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -