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?

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

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

    <p>ECG baseline assessment</p> Signup and view all the answers

    What is recommended for patients with an abnormal baseline ECG?

    <p>Referral to a cardiologist</p> Signup and view all the answers

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

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

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

    <p>3D echocardiography</p> Signup and view all the answers

    What is recommended in all patients with cancer having echocardiography?

    <p>GLS is recommended</p> Signup and view all the answers

    Who should undergo baseline comprehensive TTE before starting anticancer therapy?

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

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

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

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

    <p>Baseline echocardiography</p> Signup and view all the answers

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

    <p>High- and very high-risk patients</p> Signup and view all the answers

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

    <p>Before every cycle and 3 and 12 months after therapy completion</p> Signup and view all the answers

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

    <p>Baseline echocardiography</p> Signup and view all the answers

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

    <p>TTE every 3 months and within 1 month after therapy completion</p> 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.

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