It is indeed an exciting and wonderful time in Medicine, as many deadly diseases such as heart disease and cancer are losing their power to the persevering collaborations between physicians and researchers worldwide. Emerging new fields are playing an essential role in our fight against these once dreaded diseases, among them is one of the fastest-growing and most innovative fields: Cardio-Oncology.
With a clinical focus on advanced cardiovascular care in cancer patients, Cardio-Oncology is the intersection of cancer and cardiovascular disease at many levels: shared common risk factors, overlapping molecular biology mechanism, cardiotoxicities of cancer therapeutics, and unique risk of cardiovascular disease in cancer survivors.
Advances in cancer treatment have led to improved survival from cancer worldwide. There are an estimated 15.5million cancer survivors currently living in the United States. However, the treatment side effects, especially cardiotoxicities, from cancer therapeutics have been an important cause of morbidity and mortality in these patients. As a result, cardiovascular disease is the most common cause of non-cancer deaths in cancer survivors in the United States. Cardio-Oncology has emerged not only due to the need for comprehensive and optimal care for these patients but also due to the mutual interests from specialists in Cardiology, Oncology and other related fields in understanding the interaction between the cardiovascular system and cancer therapeutics, both traditional and innovative treatment, such as targeted and immune therapies.
Although the field of Cardio-oncology has been constantly growing and drawing more and more interest, the evidence, guidelines, and standards of clinical care are still at an early, evolving stage. This makes collaboration and resource sharing at international level indispensable in order to move the field forward. We hope this platform can provide the resource needed to facilitate the education, collaboration, and advancement of the patient care and research in the field of Cardio-Oncology.
Yan Liu, MD, Ph.D., RPVI, FACC
– Cardiotoxicities of Cancer Therapeutics – Dr. Yan Liu
(Link to an attached table in English)
(Link to an attached table in Chinese)
(see separate attached table in both English and Chinese)
– Radiation therapy and its cardiotoxicity – Dr. Cynthia Taub
(link to attached PDF)
– Immune checkpoint inhibitor & cardio-immune oncology – Dr. Yan Liu
(Link to pending PDF)
The advances in tumor immunology and development of effective cancer immunotherapies are at the center stage of the Oncology field. Novel immunotherapy, Immune checkpoint inhibitors (ICIs), have revolutionized the management of a wide variety of malignancies endowed with poor prognosis, however, they have also been linked to severe and often fulminant cardiotoxicities, with recent literature even suggesting an underestimation of these side effects. The ICI-related cardiotoxicities are unique due to the underlying pathophysiology of cancer immunosurveillance and immunoediting, and therefore cardio-immune oncology is here proposed as a new principle to advance the knowledge in this venue with the collaboration between cardiologists, oncologists, and immunologists. As a cardiologist, immunologist and cancer/aging researcher myself, I could not be more excited about this wonderful time of Medicine. We will be updating this section after the OCC meeting when I will discuss this topic in a designated talk.
– Guidelines and evidence
ESC Guidelines 2016
Link to PDF: Here
Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J 2016;37:2768-801.
NCCN Guidelines: Here