Cardiovascular Toxicity Risk Assessment in Cancer Therapy

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Questions and Answers

What is recommended for all patients with cancer before starting potentially cardiotoxic anticancer therapy?

Cardiac biomarker assessment

CV toxicity risk stratification (correct)

ECG baseline assessment

Cardiology referral

What should be done for patients categorized as low CV toxicity risk?

Proceed with anticancer therapy without delay (correct)

Delay anticancer therapy

Monitor for cardiac biomarkers

Refer to a cardiologist

When is cardiology referral recommended?

For patients with abnormal ECG findings

Only for high-risk and very high-risk patients (correct)

For all patients with cancer

For patients with pre-existing CVD

What should be discussed in a multidisciplinary approach prior to starting treatment?

The risk/benefit balance of cardiotoxic anticancer treatment Signup and view all the answers

What is recommended as part of the baseline CV risk assessment?

ECG baseline assessment Signup and view all the answers

What is recommended for patients with an abnormal baseline ECG?

Referral to a cardiologist Signup and view all the answers

What is recommended for cardiac biomarker assessment prior to potentially cardiotoxic therapies?

Baseline measurement of NP and/or cTn Signup and view all the answers

What is recommended as the preferred echocardiographic modality to measure LVEF?

3D echocardiography Signup and view all the answers

What is recommended in all patients with cancer having echocardiography?

GLS is recommended Signup and view all the answers

Who should undergo baseline comprehensive TTE before starting anticancer therapy?

Patients with cancer at high risk and very high risk of CV toxicity Signup and view all the answers

What is recommended before, during, and after cancer therapy for primary prevention of cancer therapy-related cardiovascular toxicity?

Management of CVRF according to the 2021 ESC Guidelines on CVD prevention in clinical practice Signup and view all the answers

What is recommended in all patients with cancer before anthracycline chemotherapy?

Baseline echocardiography Signup and view all the answers

In which patients is echocardiography recommended every 2 cycles and within 3 months after completing treatment?

High- and very high-risk patients Signup and view all the answers

When is cTn and NP monitoring recommended in high- and very high-risk patients during anthracycline chemotherapy?

Before every cycle and 3 and 12 months after therapy completion Signup and view all the answers

What is recommended before HER2-targeted therapies in all patients?

Baseline echocardiography Signup and view all the answers

What is recommended in patients receiving neoadjuvant or adjuvant HER2-targeted therapies?

TTE every 3 months and within 1 month after therapy completion Signup and view all the answers

Study Notes

CV Toxicity Risk Stratification

CV toxicity risk stratification is recommended for all patients with cancer before starting potentially cardiotoxic anticancer therapy.
Communicating the results of the CV toxicity risk assessment to the patient and other healthcare professionals is recommended.
Patients with low CV toxicity risk can proceed with anticancer therapy without delay.

Cardiology Referral

Cardiology referral is recommended for high-risk and very high-risk patients before anticancer therapy.
Referral is also recommended for patients with cancer and pre-existing CVD or abnormal findings at baseline CV toxicity risk assessment.

ECG Baseline Assessment

An ECG is recommended in all patients starting cancer therapy as part of their baseline CV risk assessment.
Referral to a cardiologist is recommended for patients with an abnormal baseline ECG.

Cardiac Biomarker Assessment

Baseline measurement of NP and/or cTn is recommended in all patients with cancer at risk of CTRCD if these biomarkers are going to be measured during treatment.

Cardiac Imaging Modalities

Echocardiography is recommended as the first-line modality for the assessment of cardiac function in patients with cancer.
3D echocardiography is recommended to measure LVEF.
GLS is recommended in all patients with cancer having echocardiography, if available.
Baseline cardiac imaging prior to potentially cardiotoxic therapies is recommended in high-risk and very high-risk patients.

Primary Prevention of CTRCD

Management of CVRF according to the 2021 ESC Guidelines on CVD prevention in clinical practice is recommended before, during, and after cancer therapy.

Secondary Prevention of CTRCD

Management of CVD according to applicable ESC Guidelines is recommended before, during, and after cancer therapy.

Baseline Risk Assessment and Monitoring during Anthracycline Chemotherapy

Baseline echocardiography is recommended in all patients with cancer before anthracycline chemotherapy.
Echocardiography is recommended within 12 months after completing treatment in all adults receiving anthracycline chemotherapy.
In high- and very high-risk patients, echocardiography is recommended every two cycles and within 3 months after completing treatment.
Baseline measurement of NP and cTn is recommended in high- and very high-risk patients prior to anthracycline chemotherapy.
Monitoring of cTn and NP is recommended before every cycle during anthracycline chemotherapy and 3 and 12 months after therapy completion in high- and very high-risk patients.

Baseline Risk Assessment and Monitoring during HER2-Targeted Therapies

Baseline echocardiography is recommended before HER2-targeted therapies in all patients.
Echocardiography is recommended every 3 months and within 1 year after completing therapy in patients receiving neoadjuvant or adjuvant HER2-targeted therapies.

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Description

This quiz assesses knowledge on cardiovascular toxicity risk stratification in cancer patients undergoing anticancer therapy. It covers recommendations for patient categorization and cardiology referrals.