4.4 Review

Oral Oncolytics and Cardiovascular Risk Management and Monitoring

Journal

JOURNAL OF CARDIOVASCULAR PHARMACOLOGY
Volume 82, Issue 4, Pages 266-280

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/FJC.0000000000001458

Keywords

cardiovascular disease; cardiovascular toxicity; oral oncolytics; cardiovascular monitoring; oral chemotherapy; targeted therapy

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The availability of supplemental digital content emphasizes the importance of monitoring and managing cardiovascular disease in patients undergoing oral oncolytic treatment. Evaluating cardiovascular risk factors before starting oral oncolytic therapy is necessary due to the potential negative cardiovascular effects such as left ventricular dysfunction, hypercholesterolemia, hypertension, and arrhythmias. This review emphasizes the need to assess traditional cardiovascular risk factors and their relationship with cancer development and progression. It also suggests approaches to monitor for cardiovascular adverse events and manage cardiovascular disease during and after treatment with oral oncolytic therapy. Collaborative decision making among oncologists, cardio-oncologists, pharmacists, and other healthcare professionals is essential in addressing cardiac toxicities.
Supplemental Digital Content is Available in the Text. Oral oncolytic treatment options have expanded over the last decade and have brought to light the need to monitor and manage cardiovascular (CV) disease in patients being treated with these therapies. There is a need to assess CV risk before patients receive oral oncolytic therapy with known potential to cause negative CV sequelae such as left ventricular dysfunction, hypercholesterolemia, hypertension, and arrhythmias. The review highlights the need to evaluate traditional CV risk factors and their association with the development and progression of cancer. In addition, this review suggests approaches to monitor for CV adverse events and manage CV disease during and after treatment with oral oncolytic therapy. Key guideline recommendations are reviewed and highlight specific approaches to minimize CV harm for patients exposed to oral oncolytic therapy. Careful monitoring and patient-centered decision making are key in choosing appropriate therapies. A multidisciplinary approach between oncologists, cardio-oncologists, pharmacists, and other members of the health care team is essential in navigating cardiac toxicities.

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