Predicting Risk of Cardiotoxic Effects in Breast Cancer: Are We There Yet?

Averbuch, Tauben; Mamas, Mamas A.; Van Spall, Harriette G. C.

Abstract

People with breast cancer are at increased risk of cardiovascular disease, myocardial injury, and heart failure (HF) due to underlying risk factors, a proinflammatory milieu, and cancer therapy–related cardiovascular toxic effects (CTR-CVT).1 Of the therapies for breast cancer, human epidermal growth factor receptor-2 (ERBB2)–targeted therapies, such as trastuzumab, and anthracyclines, such as doxorubicin, have the most well-described associations with both decline in left ventricular ejection fraction (LVEF), and clinical HF.2,3 Given that cardiotoxic effects are not always reversible and can result in significant morbidity and mortality, current European Society of Cardiology guidelines recommend risk stratification before starting potentially cardiotoxic anticancer therapy in all patients with cancer (Class 1B) to identify patients who are at high risk of developing CTR-CVT.4 Several risk prediction models have been developed to estimate adverse cardiac outcomes among patients with breast cancer. However, the design, performance, and methodological rigor of the risk prediction models have not been assessed systematically.

Citation

Averbuch, T., Mamas, M. A., & Van Spall, H. G. C. (in press). Predicting Risk of Cardiotoxic Effects in Breast Cancer: Are We There Yet?. Jama Network Open, 6(2), e230577. https://doi.org/10.1001/jamanetworkopen.2023.0577

• Journal Article Type: Article
• Acceptance Date: Feb 23, 2023
• Online Publication Date: Feb 23, 2023
• Deposit Date: Jan 24, 2024
• Journal: JAMA Network Open
• Print ISSN: 2574-3805
• Publisher: American Medical Association
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 2
• Pages: e230577
• DOI: https://doi.org/10.1001/jamanetworkopen.2023.0577
• Keywords: General Medicine
• Publisher URL: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801747