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Cardiac Chemotherapy

Shotaro Sakka, Koji Kawai, Ippei Tsujimoto, Masahiro Kurobe, Daishi Ichioka, Shuya Kantori, Takahiro Kojima, Takahiro Suetomi, Akira Jouraku, Jun Miyazaki, Tomoya Hoshi, Hiroyuki Nishiyama
A 37-year-old man presented at our hospital. Pathological examination of a right orchiectomy specimen, radiographic examination, and tumor marker profile resulted in a diagnosis of retroperitoneal nonseminomatous germ cell tumor (intermediate risk according to IGCC classification). Laboratory testing revealed mild elevation of low density lipoprotein cholesterol. Induction chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started, but he complained of chest pain on day 10 of the second cycle of BEP...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Paolo Spallarossa, Nicola Maurea, Christian Cadeddu, Rosalinda Madonna, Donato Mele, Ines Monte, Giuseppina Novo, Pasquale Pagliaro, Alessia Pepe, Carlo G Tocchetti, Concetta Zito, Giuseppe Mercuro
Anthracyclines are the mainstay of treatment of a variety of haematological malignancies and solid tumours. Unfortunately, the clinical use of these drugs is limited by cumulative, dose-related cardiotoxicity which may ultimately lead to a severe and irreversible form of cardiomyopathy. Thus, there is an increasing need for close cooperation among cardiologists, oncologists and haemato-oncologists. As anthracyclines save lives, the logical goal of this cooperation, besides preventing or mitigating cardiotoxicity, is to promote an acceptable balance between the potential cardiac side effects and the vital benefit of anticancer treatment...
May 2016: Journal of Cardiovascular Medicine
Alessia Pepe, Fausto Pizzino, Paola Gargiulo, Pasquale Perrone-Filardi, Christian Cadeddu, Donato Mele, Ines Monte, Giuseppina Novo, Concetta Zito, Gianluca Di Bella
Chemotherapy-induced cardiotoxicity (CTX) is a determining factor for the quality of life and mortality of patients administered potentially cardiotoxic drugs and in long-term cancer survivors. Therefore, prevention and early detection of CTX are highly desirable, as is the exploration of alternative therapeutic strategies and/or the proposal of potentially cardioprotective treatments. In recent years, cardiovascular imaging has acquired a pivotal role in this setting. Although echocardiography remains the diagnostic method most used to monitor cancer patients, the need for more reliable, reproducible and accurate detection of early chemotherapy-induced CTX has encouraged the introduction of second-line advanced imaging modalities, such as cardiac magnetic resonance (CMR) and nuclear techniques, into the clinical setting...
May 2016: Journal of Cardiovascular Medicine
Concetta Zito, Luca Longobardo, Christian Cadeddu, Ines Monte, Giuseppina Novo, Sonia Dell'Oglio, Alessia Pepe, Rosalinda Madonna, Carlo G Tocchetti, Donato Mele
The evaluation by cardiovascular imaging of chemotherapy patients became a central topic in the last several years. The use of drugs for the treatment of cancers increased, and new molecules and protocols were developed to improve outcomes in these patients. Although, these novel approaches also produced a progressive increase in side effects, particularly myocardial dysfunction. Imaging of the heart was highly accurate in the early diagnosis of cancer therapeutics related-cardiac dysfunction. Echocardiography is the first-line method to assess ventricular function alterations, and it is required to satisfy the need for an early, easy and accurate diagnosis to stratify the risk of heart failure and manage treatments...
May 2016: Journal of Cardiovascular Medicine
Muhammad W Saif, Melissa Smith, Antonio Maloney
5-Fluorouracil (5-FU) is the backbone of the chemotherapy regimens approved for treatment of many malignancies, especially colorectal cancer (CRC). The incidence of cardiotoxicity associated with 5-FU ranges between 1.5% to 18% and is most commonly manifested as anginal symptoms. Cardiomyopathy is very rarely reported with 5-FU and capecitabine. A 35-year-old Caucasian male with T3, N1, M0 rectal cancer after the initial neoadjuvant chemoradiation with 5FU/LV followed by surgical abdominoperineal resection (APR), began mFOLFOX6 in the adjuvant setting...
September 14, 2016: Curēus
Haruka Chino, Yosuke Amano, Yasuhiro Yamauchi, Jun Matsuda, Norihiko Takeda, Goh Tanaka, Daiya Takai, Takahide Nagase
We report the case of a 55-year-old man with stage IV lung adenocarcinoma who received carboplatin-paclitaxel-bevacizumab chemotherapy as second-line therapy. After four cycles of chemotherapy, he experienced syncope with a decrease in blood pressure. Electrocardiography (ECG) revealed atrial fibrillation. Cardiac ultrasonography showed a markedly reduced ejection fraction (45%), with moderate decrease in comparison to that before chemotherapy (66%). Bisoprolol fumarate was initiated, and the conversion to sinus rhythm was detected by ECG 4 days after the syncope...
September 2016: Journal of Thoracic Disease
Christina K Speirs, Todd A DeWees, Sana Rehman, Alerson Molotievschi, Maria A Velez, Daniel Mullen, Sandra Fergus, Marco Trovo, Jeffrey D Bradley, Cliff G Robinson
INTRODUCTION: In the randomized trial of standard vs high dose chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer (LA-NSCLC) (RTOG 0617), overall survival (OS) was worse in the high dose arm. While heart dose was suggested as a contributing factor, actionable parameters have not been established. We present an analysis of clinical and dosimetric parameters impacting OS in this patient population, focusing on heart dose. METHODS: Clinical data was collected on 416 patients with LA-NSLC treated at a single institution, with a subset of 333 available treatment plans re-contoured using RTOG normal tissue guidelines...
October 12, 2016: Journal of Thoracic Oncology
Chaeyoun Oh, Joong Kee Youn, Ji-Won Han, Gi Beom Kim, Hyun-Young Kim, Sung-Eun Jung
INTRODUCTION: The Fontan procedure (FP) has become the standard operation for patients with single ventricle physiology. However, a long period of elevated systemic venous pressure and low cardiac output after the procedure result in chronic inflammation and liver cirrhosis, which may eventually lead to the occurrence of hepatocellular carcinoma (HCC). CLINICAL FINDINGS: We described the case of a 16-year-old female who developed HCC after the FP. At 21 months, the patient received a lateral tunnel FP, and 14 years later, she began complaining of abdominal distension, telangiectasia, and fatigue...
October 2016: Medicine (Baltimore)
Christopher A Seid, Kathryn M Jones, Jeroen Pollet, Brian Keegan, Elissa Hudspeth, Molly Hammond, Junfei Wei, C Patrick McAtee, Leroy Versteeg, Amanda Gutierrez, Zhuyun Liu, Bin Zhan, Jonathan L Respress, Ulrich Strych, Maria Elena Bottazzi, Peter J Hotez
A therapeutic vaccine for human Chagas disease is under development by the Sabin Vaccine Institute Product Development Partnership. The aim of the vaccine is to significantly reduce the parasite burden of Trypanosoma cruzi in humans, either as a standalone product or in combination with conventional chemotherapy. Vaccination of mice with Tc24 formulated with monophosphoryl-lipid A (MPLA) adjuvant results in a Th1 skewed immune response with elevated IgG2a and IFNγ levels and a statistically significant decrease in parasitemia following T...
October 13, 2016: Human Vaccines & Immunotherapeutics
Asish K Ghosh, Rahul Rai, Kitae E Park, Mesut Eren, Toshio Miyata, Lisa D Wilsbacher, Douglas E Vaughan
Doxorubicin, an anthracycline antibiotic, is a commonly used anticancer drug. In spite of its widespread usage, its therapeutic effect is limited by its cardiotoxicity. On the cellular level, Doxorubicin-induced cardiotoxicity manifests as stress induced premature senescence. Previously, we demonstrated that plasminogen activator inhibitor-1 (PAI-1), a potent inhibitor of serine proteases, is an important biomarker and regulator of cellular senescence and aging. Here, we tested the hypothesis that pharmacological inhibition of cellular PAI-1 protects against stress- and aging-induced cellular senescence and delineated the molecular basis of protective action of PAI-1 inhibition...
October 6, 2016: Oncotarget
Kozo Nagai, Yukari Suyama, Daisuke Koga, Masanori Nishi, Chiaki Iida, Katsuya Tashiro, Atsushi Danjo, Keita Kai, Muneaki Matsuo
We described an 11-year-old boy suffering from pediatric anaplastic lymphoma kinase-positive anaplastic large cell lymphoma with heart metastasis at diagnosis and arterial tumor embolisms during chemotherapy. Both the heart metastasis and pericardial effusion showed improvement with prednisolone, but numbness and pallor sequentially developed in his lower extremities during the first course of chemotherapy. Contrast-enhanced imaging revealed occlusion of the right anterior tibial artery and left popliteal artery...
May 2016: Case Reports in Oncology
Katarzyna Rygiel
Advances in oncologic therapies have allowed many patients with breast cancer to achieve better outcomes and longer survival. However, this progress has been tempered by cardiotoxicity, associated with anticancer therapies, ranging from subclinical abnormalities to irreversible life-threatening complications, such as congestive heart failure or cardiomyopathy. In particular, exposure to chemotherapy (CHT), including anthracyclines and trastuzumab, can lead to cardiac dysfunction with short- or long-term consequences, among patients with breast cancer...
September 2016: Indian Journal of Pharmacology
Hua Li, Shouguo Yang, Hao Chen, Zhaohua Yang, Tao Hong, Yingyong Hou, Chunsheng Wang
BACKGROUND: Heart transplantation is an uncommon treatment for unresectable and non-metastatic primary cardiac sarcomas, and the role of it is unclear. This study aims to offer a survival analysis of it. METHODS: This study consists of 6 patients from our institution and 40 patients identified in a literature search who underwent heart transplantation for non-metastatic primary cardiac sarcomas. Seven patients with unresectable cardiac angiosarcoma who received palliative therapies at our institution were included for comparison...
October 3, 2016: Journal of Cardiothoracic Surgery
Wei-Ting Chang, Jhih-Yuan Shih, Yin-Hsun Feng, Chun-Yen Chiang, Yu Hsuan Kuo, Wei-Yu Chen, Hong-Chang Wu, Juei-Tang Cheng, Jhi-Joung Wang, Zhih-Cherng Chen
BACKGROUND: As cancer therapies have improved, patient life spans have been extended but quality of life has been threatened by chemotherapy induced cardiotoxicity. Most cardiac complications remain unobserved until specific symptoms develop. Speckle-tracking echocardiography is a sensitive imaging modality in detecting early occult myocardial dysfunction. METHODS: A total number of 35 patients newly diagnosed with breast cancer and preparing for epirubicin therapy were prospectively recruited...
September 2016: Acta Cardiol Sin
Juan Eduardo Megías-Vericat, Pau Montesinos, María José Herrero, Federico Moscardó, Virginia Bosó, Luis Rojas, David Martínez-Cuadrón, David Hervás, Blanca Boluda, Ana García-Robles, Rebeca Rodríguez-Veiga, María Martín-Cerezuela, José Cervera, Luis Sendra, Jaime Sanz, Antonio Miguel, Ignacio Lorenzo, José Luis Poveda, Miguel Ángel Sanz, Salvador F Aliño
Anthracycline uptake could be affected by efflux pumps of the ABC family. The influence of 7 SNPs of ABC genes was evaluated in 225 adult de novo acute myeloid leukemia (AML) patients. After multivariate logistic regression there were no significant differences in complete remission, though induction death was associated to ABCB1 triple variant haplotype (p = .020). The ABCB1 triple variant haplotype was related to higher nephrotoxicity (p = .016), as well as this haplotype and the variant allele of ABCB1 rs1128503, rs2032582 to hepatotoxicity (p = ...
October 4, 2016: Leukemia & Lymphoma
Christian Cadeddu, Alessandra Piras, Mariele Dessì, Clelia Madeddu, Giovanni Mantovani, Mario Scartozzi, Andreas Hagendorff, Paolo Colonna, Giuseppe Mercuro
Trastuzumab (TZB) has been shown to be extremely effective in breast cancer patients over-expressing HER-2, but careful cardiac monitoring is required when TZB is administered with anthracyclines, since the combination can increase its toxicity. Myocardial deformation indexes associated with speckle tracking echocardiography (STE) have proven to be very sensitive in identifying early myocardial dysfunction. An observational, prospective study was designed to assess TZB-induced cardiac damage using STE in patients with HER-2 positive breast cancer who had been sequentially treated with TZB following epirubicin (EPI)...
October 1, 2016: International Journal of Cardiovascular Imaging
Angela Dispenzieri, Giampaolo Merlini
Immunoglobulin light chain amyloidosis (AL) is a rare, complex disease caused by misfolded free light chains produced by a usually small, indolent plasma cell clone. Effective treatments exist that can alter the natural history, provided that they are started before irreversible organ damage has occurred. The cornerstones of the management of AL amyloidosis are early diagnosis, accurate typing, appropriate risk-adapted therapy, tight follow-up, and effective supportive treatment. The suppression of the amyloidogenic light chains using the cardiac biomarkers as guide to choose chemotherapy is still the mainstay of therapy...
2016: Cancer Treatment and Research
John W Smith, Marc E Buyse, Priya Rastogi, Charles E Geyer, Samuel A Jacobs, Erica J Patocskai, André Robidoux, Alison K Conlin, Bilal Ansari, George P Keogh, Philip J Stella, Howard M Gross, Raymond S Lord, Jonathan A Polikoff, Celine Mauquoi, Eleftherios P Mamounas, Sandra M Swain, Norman Wolmark
BACKGROUND: The purpose of this study was to determine the cardiac safety and clinical activity of trastuzumab and bevacizumab with docetaxel after epirubicin with cyclophosphamide (EC) in patients with HER2-positive locally advanced breast cancer (LABC) or pathologic stage 3 breast cancer (PS3BC). PATIENTS AND METHODS: Patients received every 3 week treatment with 4 cycles of EC (90/600 mg/m(2)) followed by 4 cycles of docetaxel (100 mg/m(2)). Targeted therapy with standard-dose trastuzumab with bevacizumab 15 mg/kg was given for a total of 1 year...
July 28, 2016: Clinical Breast Cancer
Mohammad S Diab, Jeremy Smelt, Nick Fletcher, Mazin Sarsam
Cardiac sarcoma's are highly aggressive tumours. Clear resection margins ± autotransplant, followed by chemotherapy, offers the best survival chance. Therefore, frozen section should be preformed when there is ambiguity in diagnosis.
September 2016: JRSM Open
Michèle Voegeli, Stephanie Rondeau, Simona Berardi Vilei, Erika Lerch, Luciano Wannesson, Thomas Pabst, Jochen Rentschler, Mario Bargetzi, Lorenz Jost, Nicolas Ketterer, Angelika Bischof Delaloye, Michele Ghielmini
Standard conditioning regimens for autologous stem cell transplantation (ASCT) are often not tolerated by elderly patients, on one hand. Single high-dose melphalan, on the other hand, has been shown to be safe and active as a pretransplant preparative regimen in elderly patients. Y(90) -Ibritumomab tiuxetan (Y(90) -IT) is well tolerated and feasible in the transplantation setting. We therefore investigated the combination of high-dose melphalan and Y(90) -IT as a conditioning regimen for patients ≥65 years of age...
September 28, 2016: Hematological Oncology
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