Onco-Cardiology: Consensus Paper of the German Cardiac Society, the German Society for Pediatric Cardiology and Congenital Heart Defects and the German Society for Hematology and Medical Oncology

Abstract

The acute and long-lasting side effects of modern multimodal tumour therapy significantly impair quality of life and survival of patients afflicted with malignancies. The key components of this therapy include radiotherapy, conventional chemotherapy, immunotherapy and targeted therapies. In addition to established tumour therapy strategies, up to 30 new therapies are approved each year with only incompletely characterised side effects. This consensus paper discusses the risk factors that contribute to the development of a potentially adverse reaction to tumour therapy and, in addition, defines specific side effect profiles for different treatment groups. The focus is on novel therapeutics and recommendations for the surveillance and treatment of specific patient groups.

Keywords: Cancer therapy; Cardio-oncology; Cardiotoxicity; Chemotherapy; Survivorship programs.

Fig. 1

Interaction of genetic predisposition, classic risk factors and pre-existing cardiovascular diseases in the development or progression of a cardiovascular disease as a result of cancer therapy (‘2nd hit’) or the cancer itself. CAD coronary artery disease, PAD peripheral artery disease, LV left ventricular

Fig. 2

Algorithm for cardiological follow-up after mediastinal irradiation. Gy Gray, ECG electrocardiogram, echo echocardiography, CT computed tomography

Fig. 3

Outline of recommended baseline and follow-up examinations for immune checkpoint inhibitor therapy. Given the frequent association with myositis, it makes sense to measure troponin and creatinine kinase (CK) in parallel. CMR cardiac magnetic resonance imaging, ECG electrocardiogram, echo echocardiography