Permissive Cardiotoxicity: The Clinical Crucible of Cardio-Oncology

Charles Porter; Tariq U. Azam; Divyanshu Mohananey; Rohit Kumar; Jian Chu; Daniel Lenihan; Susan Dent; Sarju Ganatra; Gary S. Beasley; Tochukwu Okwuosa

doi:10.1016/j.jaccao.2022.07.005

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Permissive Cardiotoxicity: The Clinical Crucible of Cardio-Oncology

Journal article

Open access

Peer reviewed

Permissive Cardiotoxicity: The Clinical Crucible of Cardio-Oncology

Charles Porter, Tariq U. Azam, Divyanshu Mohananey, Rohit Kumar, Jian Chu, Daniel Lenihan, Susan Dent, Sarju Ganatra, Gary S. Beasley and Tochukwu Okwuosa

JACC CardioOncology, Vol.4(3), pp.302-312

09/20/2022

DOI: 10.1016/j.jaccao.2022.07.005

PMCID: PMC9537074

PMID: 36213359

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Abstract

The field of cardio-oncology was born from the necessity for recognition and management of cardiovascular diseases among patients with cancer. This need for this specialty continues to grow as patients with cancer live longer as a result of lifesaving targeted and immunologic cancer therapies beyond the usual chemotherapy and/or radiation therapy. Often, potentially cardiotoxic anticancer treatment is necessary in patients with baseline cardiovascular disease. Moreover, patients may need to continue therapy in the setting of incident cancer therapy–associated cardiotoxicity. Herein, we present and discuss the concept of permissive cardiotoxicity as a novel term that represents an essential concept in the field of cardio-oncology and among practicing cardio-oncology specialists. It emphasizes a proactive rather than reactive approach to continuation of lifesaving cancer therapies in order to achieve the best oncologic outcome while mitigating associated and potentially off-target cardiotoxicities. • Permissive cardiotoxicity is a terminology that represents a vital concept in cardio-oncology • It emphasizes continued cancer therapy if appropriate, while mitigating cardiotoxicities. • Its application is guided by understanding the cancer treatment, alternatives, and prognosis.

5-FU, 5-fluorouracil

CAD, coronary artery disease

cardiomyopathy

CV, cardiovascular

CVD, cardiovascular disease

diagnosis

GDMT, guideline-directed medical therapy

GLS, global longitudinal strain

HER2 therapy

HER2, human epidermal growth factor receptor 2

HSCT, hematopoietic stem cell transplantation

ICI, immune checkpoint inhibitor

immunotherapy

LVEF, left ventricular ejection fraction

prevention

Primers in Cardio-Oncology

risk factor

risk prediction

screening

treatment planning

VEGF, vascular endothelial growth factor

Details

Title: Subtitle: Permissive Cardiotoxicity: The Clinical Crucible of Cardio-Oncology
Creators: Charles Porter - University of Kansas Medical Center
Tariq U. Azam - University of Michigan
Divyanshu Mohananey - Medical College of Wisconsin
Rohit Kumar - University of Louisville
Jian Chu - Rush University
Daniel Lenihan - International Cardio-Oncology Society, Tampa, Florida, USA
Susan Dent - Duke University
Sarju Ganatra - Lahey Hospital and Medical Center
Gary S. Beasley - University of Iowa
Tochukwu Okwuosa - Rush University
Resource Type: Journal article
Publication Details: JACC CardioOncology, Vol.4(3), pp.302-312
DOI: 10.1016/j.jaccao.2022.07.005
PMID: 36213359
PMCID: PMC9537074
NLM abbreviation: JACC CardioOncol
ISSN: 2666-0873
eISSN: 2666-0873
Publisher: Elsevier
Language: English
Date published: 09/20/2022
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9984353843202771

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