Personalized Medicine in Cardio-Oncology

A special issue of Journal of Personalized Medicine (ISSN 2075-4426).

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 4986

Special Issue Editors


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Guest Editor
Breast Unit, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, 80131 Napoli, Italy
Interests: cancer; breast cancer; translational research; clinical trials

Special Issue Information

Dear Colleagues,

Several therapies have significantly increased the survival of cancer patients; however, a high risk of adverse cardiac outcomes, such as heart failure (HF) and cardiomyopathy (CM), has also been observed. Innovative anticancer therapies, such as PARP inhibitors, immune check-point inhibitors, CDK-4/6 inhibitors, and new HER-2 blocking agents, available in clinical trials and then integrated in clinical practice, have also shown cardiotoxicity effects, such as abnormalities in left ventricular function, leading to HF or CM, vasculotoxicity and metabolic diseases. The risk of severe cardiotoxicity could be higher in cancer patients already treated with standard chemotherapies, such as anthracyclines, affecting the therapeutical choices of clinicians. This Special Issue welcomes systematic reviews and communications, as well as original research, in the fields of target therapy, vasculo-toxicity, interdisciplinary health research, preclinical models, translational and clinical research, and epidemiologic research, covering the above cardio-oncology topics.

Prof. Dr. Vincenzo Quagliariello
Dr. Stefania Cocco
Guest Editors

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Keywords

  • target therapy
  • cardio-oncology
  • cancer
  • inflammation
  • immunotherapy
  • cardio-protection
  • translation research

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Published Papers (2 papers)

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Research

16 pages, 2804 KiB  
Article
Quantification of Extracellular Volume in CT in Neoadjuvant Chemotherapy in Breast Cancer: New Frontiers in Assessing the Cardiotoxicity of Anthracyclines and Trastuzumab
by Marcello Chiocchi, Martina Cerocchi, Federica Di Tosto, Roberto Rosenfeld, Monia Pasqualetto, Gianluca Vanni, Vincenzo De Stasio, Luca Pugliese, Carlo Di Donna, Gaetano Idone, Saverio Muscoli, Ilaria Portarena, Mario Roselli, Francesco Garaci and Roberto Floris
J. Pers. Med. 2023, 13(2), 199; https://doi.org/10.3390/jpm13020199 - 22 Jan 2023
Cited by 3 | Viewed by 2012
Abstract
Breast cancer patients undergoing neoadjuvant chemotherapy with anthracyclines or trastuzumab can suffer cardiotoxic issues. Nowadays, the markers of cardiac damage are still not reliable, and extracellular volume (ECV) calculated from CT could be a promising cardiotoxic marker. Eighty-two patients, treated with two different [...] Read more.
Breast cancer patients undergoing neoadjuvant chemotherapy with anthracyclines or trastuzumab can suffer cardiotoxic issues. Nowadays, the markers of cardiac damage are still not reliable, and extracellular volume (ECV) calculated from CT could be a promising cardiotoxic marker. Eighty-two patients, treated with two different chemotherapy regimens based on doxorubicin (DOX) or epirubicin-trastuzumab (EPI–TRAS), were retrospectively selected and the variations in extracellular volume (ECV) values were measured and analyzed. Whole Body CT (WB-CT) scans were acquired after 1 min, in the portal phase (PP), and after 5 min, in the delayed phases (DP), at the baseline (T0), after one year (T1) and after five years (T5) from the end of chemotherapies. The values measured by two radiologists with different levels of experience were evaluated in order to assess the inter-reader reproducibility assessment (ICC = 0.52 for PP and DP). Further, we performed a population-based analysis and a drug-oriented subgroup analysis in 54 DOX-treated and 28 EPI–TRAS-treated patients. In the general cohort of women treated with any of the two drugs, we observed in the lapse T0–T1 a relative increase (RI) of 25% vs. 20% (PP vs. DP, p < 0.001) as well as in the lapse T0–T5 an RI of 17% vs. 15% (PP vs. DP, p < 0.01). The DOX-treated patients reported in the lapse T0–T1 an RI of 22% (p < 0.0001) in PP and an RI of 16% (p = 0.018) in the DP, with ECV values remaining stably high at T5 both in PP (RI 14.0%, p < 0.0001) and in DP (RI 17%, p = 0.005) highlighting a possible hallmark of a persisting CTX sub-damage. On the other hand, ECV measured in EPI–TRAS-treated women showed an RI in T0–T1 of 18% (p = 0.001) and 29% (p = 0.006) in PP and DP, respectively, but the values returned to basal levels in T5 both in the PP (p = 0.12) and in DP setting (p = 0.13), suggesting damage in the first-year post-treatment and a possible recovery over time. For the 82 patients, an echocardiography was performed at T0, T1= 12 m + 3 m and T5 = 60 m + 6 m with LVEF values at T0 (64% ± 5%), T1 (54% ± 6%) and T5 (53% ± 8%). WB-CT-derived ECV values could provide a valid imaging marker for the early diagnosis of cardiotoxic damage in BC patients undergoing oncological treatments. We detected different patterns during the follow-up, with stably high values for DOX, whereas EPI–TRAS showed a peak within the first year, suggesting different mechanisms of cardiac damage. Full article
(This article belongs to the Special Issue Personalized Medicine in Cardio-Oncology)
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17 pages, 2025 KiB  
Article
Echocardiographic and Cardiac MRI Comparison of Longitudinal Strain and Strain Rate in Cancer Patients Treated with Immune Checkpoint Inhibitors
by Jibran Mirza, Sunitha Shyam Sunder, Badri Karthikeyan, Sharma Kattel, Saraswati Pokharel, Brian Quigley and Umesh C. Sharma
J. Pers. Med. 2022, 12(8), 1332; https://doi.org/10.3390/jpm12081332 - 19 Aug 2022
Cited by 3 | Viewed by 2186
Abstract
Background: Immune checkpoint inhibitor (ICI)-induced cardiac side effects in cancer patients are increasingly being recognized and can be fatal. There is no standardized cardiac imaging test to examine the effects of ICIs in myocardial morphology and function. Objective: To study the utility of [...] Read more.
Background: Immune checkpoint inhibitor (ICI)-induced cardiac side effects in cancer patients are increasingly being recognized and can be fatal. There is no standardized cardiac imaging test to examine the effects of ICIs in myocardial morphology and function. Objective: To study the utility of echocardiography and cardiac MRI in examining regional and global changes arising from ICI-induced myocarditis and cardiomyopathy in high-risk subjects suspected to have developed ICI cardiomyopathy. Methods: We studied eight consecutive patients referred for cardiac MRI (CMR) from a comprehensive cancer center for suspected ICI-induced myocarditis and compared the data with sixteen age-matched controls. Using newly developed strain analysis algorithms, we measured myocardial strain and strain rates using echocardiography and CMR. Then, we compared the mean longitudinal strain and strain rates derived from echocardiography and CMR in the same ICI-treated cohort of patients (n = 8). They underwent both of these imaging studies with images taken 24–48 h apart and followed up prospectively within the same hospital course. Results: All our cases had preserved ejection fraction (EF) > 50%. Echocardiogram showed reduced mean systolic longitudinal strain (LS, %) (ICI: −12.381 ± 4.161; control: −19.761 ± 1.925; p < 0.001), peak systolic strain rate (SRS, s−1) (ICI: −0.597 ± 0.218; control: −0.947 ± 0.135; p = 0.002) and early diastolic strain rate (SRE, s−1) (ICI: 0.562 ± 0.295; control: 1.073 ± 0.228; p = 0.002) in ICI-treated cases. Direct comparison between the echocardiogram vs. CMR obtained within the same hospital course demonstrated strong a correlation of LS scores (r = 0.83, p = 0.012) and SRS scores (r = 0.71, p = 0.048). The Bland–Altman plots showed that 95% of the data points fitted within the ±1.96 SD of the mean difference, suggesting an agreement among these two imaging modalities. Conclusion: In this feasibility cohort study, both echocardiography- and CMR-based strain indices illustrate changes in myocardial contractility and relaxation suggestive of ICI-induced cardiomyopathy. Our data, after validation in a larger cohort, can form the basis of myocardial imaging in cancer patients treated with ICIs. Full article
(This article belongs to the Special Issue Personalized Medicine in Cardio-Oncology)
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