Cardiovascular Toxicity and Risk Mitigation with Lung Cancer Treatment

Curr Oncol Rep. 2023 May;25(5):433-444. doi: 10.1007/s11912-023-01387-4. Epub 2023 Feb 22.

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. 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.

Keywords: Cardio-oncology; Cardiotoxicity; Immunotherapy; Lung cancer; MACE; Radiation therapy.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Cardiotoxicity / drug therapy
  • Cardiotoxicity / etiology
  • Cardiotoxicity / prevention & control
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / prevention & control
  • Cardiovascular System*
  • Humans
  • Lung
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / radiotherapy
  • Neoplasms* / drug therapy

Substances

  • Antineoplastic Agents