Publication:

Efficacy of integrating cardiovascular risk management into cancer treatment protocols: a systematic review of current strategies and innovations

Many of the anti-cancer agents, including anthracyclines, human epidermal growth factor receptor (HER2) inhibitors, and tyrosine kinase inhibitors are known to have cardiotoxic potential with potential consequences including heart failure, arrhythmias and myocardial ischemia. Therefore, the following systematic review questions have been developed to assess the effectiveness of incorporating cardiovascular risk in cancer management to counter these side effects. The literature search was extended on randomized control trials and meta-analysis in terms of cardioprotective strategies including global longitudinal strain (GLS), and ejection fraction (EF) both as guided therapy, and exercise prescription. Considering only patient characteristics, inclusion criteria included adult cancer patients receiving cardiotoxic treatments, whereas exclusion criteria excluded pediatric studies and non-randomized trials as well as trials without cardiovascular endpoints. The outcomes are evidence of lower cardiotoxicity with GLS-guided cardio-protection when compared to EF-based strategies, a decreased risk in left ventricular systolic dysfunction, and heart failure. The exercise interventions also have yielded favorable results in enhancing cardiovascular capacity and minimizing toxic consequences of chemotherapy on the cardiotoxicity level. Increasingly, eliminating and modifying cancer and oncology treatment strategies can help remedy disease outcomes; however, protocols for including these strategies in oncology plans have yet to be developed. Therefore, cardiovascular risk management conception in cancer treatment has to be regarded as crucial in avoidance of cardiotoxicity and improvement of quality of life and survival rate in oncological patients.