Cancer Drugs and Cardiovascular Toxicities

Cytotoxic chemotherapeutic agents, immunotherapy and, most recently, antiangiogenic preparations may have potential cardiovascular events associated with their use, from minor ECG changes in asymptomatic patients to cardiovascular collapse in acute, subacute or chronic clinical settings. In addition, cardiovascular complications associated with malignancy can pose problems in diagnosing and treating patients and may host a systemic, metabolic, paraneoplastic or other major organ system dysfunction that often accompanies advanced disease.1

To minimize potential cardiovascular problems, oncologists must consider numerous therapeutic issues - including drug dosage, rate of administration, single or combination agent sequencing and possible overlapping side effects - while employing drugs with different mechanisms of antitumor activity. Likewise, cardiologists must consider issues such as infection, fever, volume status, electrolyte abnormalities, age, sex, pregnancy, prior radiation and pre-existing heart disease when considering testing modalities.