Cancer Treatment-Related Cardiovascular Toxicity in Gynecologic Malignancies: JACC: CardioOncology State-of-the-Art Review

Susmita Parashar; Nausheen Akhter; Elisavet Paplomata; Islam Y Elgendy; Deepa Upadhyaya; Marielle Scherrer-Crosbie; Tochukwu M Okwuosa; Rupa M Sanghani; Eva Chalas; Kathryn J Lindley; Susan Dent

doi:10.1016/j.jaccao.2023.02.002

Cancer Treatment-Related Cardiovascular Toxicity in Gynecologic Malignancies: JACC: CardioOncology State-of-the-Art Review

JACC CardioOncol. 2023 Apr 18;5(2):159-173. doi: 10.1016/j.jaccao.2023.02.002. eCollection 2023 Apr.

Authors

Affiliations

¹ Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA.
² Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
³ Medical Director for ICON, Dublin, Ireland.
⁴ Division of Cardiology, Department of Medicine, University of Kentucky, Lexington, Kentucky, USA.
⁵ Division of Cardiology, Duke Cancer Institute, Duke University, Durham, North Carolina, USA.
⁶ Cardiovascular Medicine Division, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁷ Division of Cardio-Oncology, Department of Medicine, Rush University, Chicago, Illinois, USA.
⁸ Division of Cardiology, Department of Medicine, Rush University, Chicago, Illinois, USA.
⁹ Division of Obstetrics and Gynecology, New York University Long Island School of Medicine, Mineola, New York, USA.
¹⁰ Division of Cardiology, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
¹¹ Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, North Carolina, USA.

Abstract

Improvements in early detection and treatment of gynecologic malignancies have led to an increasing number of survivors who are at risk of long-term cardiac complications from cancer treatment. Multimodality therapies for gynecologic malignancies, including conventional chemotherapy, targeted therapeutics, and hormonal agents, place patients at risk of cancer therapy-related cardiovascular toxicity during and following treatment. Although the cardiotoxicity associated with some female predominant cancers (eg, breast cancer) have been well recognized, there has been less recognition of the potential adverse cardiovascular effects of anticancer therapies used to treat gynecologic malignancies. In this review, the authors provide a comprehensive overview of the cancer therapeutic agents used in gynecologic malignancies, associated cardiovascular toxicities, risk factors for cardiotoxicity, cardiac imaging, and prevention strategies.

Keywords: cancer; cardiovascular toxicity; gynecology; therapeutics.

Publication types

Review