Role of serum biomarkers in cancer patients receiving cardiotoxic cancer therapies: a position statement from the Cardio-Oncology Study Group of the Heart Failure Association and the Cardio-Oncology Council of the European Society of Cardiology.

Abstract

Serum biomarkers are an important tool in the baseline risk assessment and diagnosis of cardiovascular disease in cancer patients receiving cardiotoxic cancer treatments. Increases in cardiac biomarkers including cardiac troponin and natriuretic peptides can be used to guide initiation of cardioprotective treatments for cancer patients during treatment and to monitor the response to cardioprotective treatments, and they also offer prognostic value. This position statement examines the role of cardiac biomarkers in the management of cancer patients. The Cardio-Oncology Study Group of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in collaboration with the Cardio-Oncology Council of the ESC have evaluated the current evidence for the role of cardiovascular biomarkers in cancer patients before, during and after cardiotoxic cancer therapies. The characteristics of the main two biomarkers troponin and natriuretic peptides are discussed, the link to the mechanisms of cardiovascular toxicity, and the evidence for their clinical use in surveillance during and after anthracycline chemotherapy, trastuzumab and HER2-targeted therapies, vascular endothelial growth factor inhibitors, proteasome inhibitors, immune checkpoint inhibitors, cyclophosphamide and radiotherapy. Novel surveillance clinical pathways integrating cardiac biomarkers for cancer patients receiving anthracycline chemotherapy or trastuzumab biomarkers are presented and future direction in cardio-oncology biomarker research is discussed.

• Authors: Radek Pudil, Christian Mueller, Jelena Čelutkienė, Peter A Henriksen, Dan Lenihan, Susan Dent, Ana Barac, Susanna Stanway, Javid Moslehi, Thomas M Suter, Bonnie Ky, Martin Štěrba, Daniela Cardinale, Alain Cohen-Solal, Carlo Gabriele Tocchetti, Dimitrios Farmakis, Jutta Bergler-Klein, Markus S Anker, Stephan Von Haehling, Yury Belenkov, Zaza Iakobishvili, Christoph Maack, Fortunato Ciardiello, Frank Ruschitzka, Andrew J S Coats, Petar Seferovic, Mitja Lainscak, Massimo F Piepoli, Ovidiu Chioncel, Jereon Bax, Jean-Sebastien Hulot, Hadi Skouri, Eva Simona Hägler-Laube, Riccardo Asteggiano, Teresa Lopez Fernandez, Rudolf A de Boer, Alexander R Lyon
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 22 Issue 11 Pg. 1966-1983 (11 2020) ISSN: 1879-0844 [Electronic] England
• PMID: 33006257 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 European Society of Cardiology.

Chemical References

• Antineoplastic Agents
• Biomarkers, Tumor
• Cardiotonic Agents

Topics

• Antineoplastic Agents (administration & dosage, adverse effects)
• Biomarkers, Tumor (blood)
• Cardiotonic Agents (administration & dosage)
• Cardiotoxicity (blood, diagnosis, etiology)
• Heart Failure (blood, chemically induced, diagnosis)
• Humans
• Neoplasms (blood, drug therapy)