Cardiovascular Complications of Pan-Cancer Therapies: The Need for Cardio-Oncology

SIMPLE SUMMARY: Worldwide, with the steady progress of pan-cancer therapy, the long-term survival of cancer patients has increased. Inevitably, along with improved life expectancy and reduced mortality, another decisive factor has also emerged—cardiovascular complications. We focus on the heterogeneity of cardiotoxicity derived from various classes of cancer therapies. Comprehensive cardiovascular risk assessment and optimal clinical monitoring prior to, during, and after treatment should be considered in candidates for initial cancer therapy. Nevertheless, the exact mechanisms of cardiovascular adverse effects remain undefined, as do specific therapeutic targets, requiring cooperation between oncologists and cardiologists, a field known as cardio-oncology. We present an updated overview of the epidemiology and mechanism underlying the major cardiac toxic effects resulting from a range of pan-cancer therapies, with emphasis on the importance of assessing relevant risk factors. ABSTRACT: It is more likely that a long-term survivor will have both cardiovascular disease and cancer on account of the progress in cancer therapy. Cardiotoxicity is a well-recognized and highly concerning adverse effect of cancer therapies. This side effect can manifest in a proportion of cancer patients and may lead to the discontinuation of potentially life-saving anticancer treatment regimens. Consequently, this discontinuation may adversely affect the patient’s survival prognosis. There are various underlying mechanisms by which each anticancer treatment affects the cardiovascular system. Similarly, the incidence of cardiovascular events varies with different protocols for malignant tumors. In the future, comprehensive cardiovascular risk assessment and clinical monitoring should be considered for cancer treatments. Baseline cardiovascular evaluation risk should be emphasized prior to initiating clinical therapy in patients. Additionally, we highlight that there is a need for cardio-oncology to avoid or prevent cardiovascular side effects. Cardio-oncology service is based on identifying cardiotoxicity, developing strategies to reduce these toxicities, and minimizing long-term cardiotoxic effects.