Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors
Abstract Background Cancer survival rates have been steadily improving in the adolescent and young adult (AYA) population, but survivors are at increased risk for cardiovascular disease (CVD). The cardiotoxic effects of anthracycline therapy have been well studied. However, the cardiovascular toxici...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Cardio-Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40959-023-00181-2 |
| _version_ | 1827905189920636928 |
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| author | Jeannette R. Wong-Siegel Robert J. Hayashi Randi Foraker Joshua D. Mitchell |
| author_facet | Jeannette R. Wong-Siegel Robert J. Hayashi Randi Foraker Joshua D. Mitchell |
| author_sort | Jeannette R. Wong-Siegel |
| collection | DOAJ |
| description | Abstract Background Cancer survival rates have been steadily improving in the adolescent and young adult (AYA) population, but survivors are at increased risk for cardiovascular disease (CVD). The cardiotoxic effects of anthracycline therapy have been well studied. However, the cardiovascular toxicity associated with newer therapies, such as the vascular endothelial growth factor (VEGF) inhibitors, is less well understood. Objective This retrospective study of AYA cancer survivors sought to gain insight into their burden of cardiovascular toxicities (CT) following initiation of anthracycline and/or VEGF inhibitor therapy. Methods Data were extracted from electronic medical records over a fourteen-year period at a single institution. Cox proportional hazards regression modeling was used to examine risk factors for CT within each treatment group. Cumulative incidence was calculated with death as a competing risk. Results Of the 1,165 AYA cancer survivors examined, 32%, 22%, and 34% of patients treated with anthracycline, VEGF inhibitor, or both, developed CT. Hypertension was the most common outcome reported. Males were at increased risk for CT following anthracycline therapy (HR: 1.34, 95% CI 1.04–1.73). The cumulative incidence of CT was highest in patients who received both anthracycline and VEGF inhibitor (50% at ten years of follow up). Conclusions CT was common among AYA cancer survivors who received anthracycline and/or VEGF inhibitor therapy. Male sex was an independent risk factor for CT following anthracycline treatment. Further screening and surveillance are warranted to continue understanding the burden of CVD following VEGF inhibitor therapy. |
| first_indexed | 2024-03-13T00:39:24Z |
| format | Article |
| id | doaj.art-202f13454fda4ded914d71455369e8a9 |
| institution | Directory Open Access Journal |
| issn | 2057-3804 |
| language | English |
| last_indexed | 2024-03-13T00:39:24Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardio-Oncology |
| spelling | doaj.art-202f13454fda4ded914d71455369e8a92023-07-09T11:26:26ZengBMCCardio-Oncology2057-38042023-07-019111010.1186/s40959-023-00181-2Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivorsJeannette R. Wong-Siegel0Robert J. Hayashi1Randi Foraker2Joshua D. Mitchell3Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis Children’s HospitalDivision of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis Children’s HospitalInstitute for Informatics, Washington University School of MedicineCardio-Oncology Center of Excellence, Division of Cardiology, Washington University in St. LouisAbstract Background Cancer survival rates have been steadily improving in the adolescent and young adult (AYA) population, but survivors are at increased risk for cardiovascular disease (CVD). The cardiotoxic effects of anthracycline therapy have been well studied. However, the cardiovascular toxicity associated with newer therapies, such as the vascular endothelial growth factor (VEGF) inhibitors, is less well understood. Objective This retrospective study of AYA cancer survivors sought to gain insight into their burden of cardiovascular toxicities (CT) following initiation of anthracycline and/or VEGF inhibitor therapy. Methods Data were extracted from electronic medical records over a fourteen-year period at a single institution. Cox proportional hazards regression modeling was used to examine risk factors for CT within each treatment group. Cumulative incidence was calculated with death as a competing risk. Results Of the 1,165 AYA cancer survivors examined, 32%, 22%, and 34% of patients treated with anthracycline, VEGF inhibitor, or both, developed CT. Hypertension was the most common outcome reported. Males were at increased risk for CT following anthracycline therapy (HR: 1.34, 95% CI 1.04–1.73). The cumulative incidence of CT was highest in patients who received both anthracycline and VEGF inhibitor (50% at ten years of follow up). Conclusions CT was common among AYA cancer survivors who received anthracycline and/or VEGF inhibitor therapy. Male sex was an independent risk factor for CT following anthracycline treatment. Further screening and surveillance are warranted to continue understanding the burden of CVD following VEGF inhibitor therapy.https://doi.org/10.1186/s40959-023-00181-2Cancer therapiesCancer survivorsCardiotoxicity |
| spellingShingle | Jeannette R. Wong-Siegel Robert J. Hayashi Randi Foraker Joshua D. Mitchell Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors Cardio-Oncology Cancer therapies Cancer survivors Cardiotoxicity |
| title | Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors |
| title_full | Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors |
| title_fullStr | Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors |
| title_full_unstemmed | Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors |
| title_short | Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors |
| title_sort | cardiovascular toxicities after anthracycline and vegf targeted therapies in adolescent and young adult cancer survivors |
| topic | Cancer therapies Cancer survivors Cardiotoxicity |
| url | https://doi.org/10.1186/s40959-023-00181-2 |
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