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Cardiovascular Toxicity and Risk Mitigation with Lung Cancer Treatment

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Abstract

Purpose of Review

Patients with lung cancer often have concomitant cardiovascular comorbidities and receive potentially cardiotoxic therapies. As oncologic outcomes improve, the relative impact of cardiovascular disease on lung cancer survivors is expected to increase. This review summarizes cardiovascular toxicities observed after treatment for lung cancer, as well as recommended risk mitigation strategies.

Recent Findings

A variety of cardiovascular events may be observed after surgery, radiation therapy (RT), and systemic therapy. The risk of cardiovascular events after radiation therapy (RT) is higher than previously appreciated (23–32%), and RT dose to the heart is a modifiable risk factor. Targeted agents and immune checkpoint inhibitors have been associated with cardiovascular toxicities distinct from those of cytotoxic agents; these are rare but can be severe and require prompt intervention.

Summary

Optimization of cardiovascular risk factors is important at all phases of cancer therapy and survivorship. Recommended practices for baseline risk assessment, preventive measures, and appropriate monitoring are discussed herein.

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Authors and Affiliations

  1. Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Nikhil Yegya-Raman, Eva Berlin & Steven J. Feigenberg

  2. Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Bonnie Ky

  3. Division of Hematology Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, West Pavilion, 2nd Floor, Philadelphia, PA, 19104, USA

    Lova Sun

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  3. Steven J. Feigenberg
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  4. Bonnie Ky
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  5. Lova Sun
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Correspondence to Lova Sun.

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Dr. Ky has received grants from NIH, and the American Heart Association, and other funding from Pfizer, Roche, and American College of Cardiology. Other authors have nothing to disclose.

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Yegya-Raman, N., Berlin, E., Feigenberg, S.J. et al. Cardiovascular Toxicity and Risk Mitigation with Lung Cancer Treatment. Curr Oncol Rep 25, 433–444 (2023). https://doi.org/10.1007/s11912-023-01387-4

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