ESMO recommendations on the management of cardiac disease in cancer patients


  • Dawn O'Shea
  • Univadis Medical News
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

The European Society for Medical Oncology (ESMO) has issued recommendations on the management of cardiac disease in patients receiving cancer treatment.

Key recommendations include the following:

  • Consider prophylactic cardioprotective treatment with angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin II receptor blockers (ARBs) and/or selected beta-blockers.
  • Consider risk-benefit of continuing anthracycline in asymptomatic patients with left ventricular ejection fraction (LVEF) decrease ≥10% to 50%, or to ≥40% but
  • Cancer treatment should not be altered solely based on left ventricular (LV) strain in asymptomatic patients with normal LVEF but relative decrease in global longitudinal strain ≥12% (repeat LV strain test every 3 months), or elevated cardiac troponin.
  • Consider dexrazoxane in patients receiving anthracycline.
  • Anticancer therapy can continue if only mild elevations in cardiac biomarkers occur without significant LV dysfunction (LVD).
  • For asymptomatic patients with normal cardiac function, screen at 6-12 months and 2 years post-treatment.
  • For patients with treatment-related LVD or heart failure, continue cardiac care indefinitely.
  • For patients with a history of mediastinal radiotherapy, evaluate for coronary artery disease, ischaemia, valvular disease, starting 5 years post-treatment and then at least every 3-5 years.
  • Withhold immune checkpoint inhibitors in cases of suspected or confirmed myocarditis and start high-dose corticosteroids.

The full recommendations are published in the Annals of Oncology.