Do all chemotherapies have the same long-term cardiac risk?

In long-term survivors of childhood cancer, cardiovascular disease is one of the leading causes of premature death from causes other than cancer. In a new study, published January 31 in JAMA Oncology, the researchers compared four chemotherapy drugs with the development of cardiomyopathy (abnormal heart muscle with impaired function) years after treatment.

"Exposure to anthracycline-based chemotherapies, such as doxorubicin, has long been badociated with an increased risk of cardiovascular disease among survivors of long-term childhood cancer." term, "said Gregory Aune, MD, Ph.D., of UT Health San Antonio. "Previously, it was badumed that exposure to any member of the anthracycline clbad had the same risk of late cardiovascular complications." Studying the results in over 28,000 long-term survivors in the United States United and Europe, this research indicates that exposure to different anthracyclines gives long-term variable cardiovascular risk.In the future, it will be important to consider these differences when screening for cardiovascular complications in survivors in the long term and in the development of modern treatment regimens. "

The drug, daunorubicin, has been badociated with a decreased risk of cardiomyopathy compared to doxorubicin. Mitoxantrone, another chemotherapy, appeared to present a longer-term risk of cardiomyopathy than previously thought.

"The last few decades have been spent designing the most effective drug combinations to treat patients," said Gail Tomlinson, MD, Ph.D., professor of pediatrics, director of the Division of Hematology-Oncology. pediatric and holds the Greehey distinction. Chair in Genetics and Cancer at UT Health San Antonio. "This process has been successful, with a substantial increase in survival for most types of cancer.Now that so many survivors are alive several years after the original cancer, it is imperative to develop protocols based on the goal of minimizing late effects. "

Dr. Aune, an Assistant Professor of Pediatric Hematology-Oncology at UT Health San Antonio and a researcher with the University's Greehey Cancer Research Institute, has been involved in the design and revision of the study. The co-authors come from the Netherlands; the Fred Hutchinson Cancer Research Center in Seattle; St. Jude Children's Research Hospital in Memphis, Tennessee; the Duke University School of Medicine; and the University of Washington, Seattle.

Provided by
Health Sciences Center of the University of Texas at San Antonio