Claire Glen, Stephen J H Dobbin, Kenneth Mangion, Alasdair Henderson, Katriona Brooksbank, Caroline J Coats, Frederick H Epstein, Peter Kellman, Elaine Butler, Thomas R Jeffry Evans, Rob Jones, John McClure, Giles Roditi, Yun Yi Tan, Ashita Waterston, Paul Welsh, Mark C Petrie, Ninian N Lang
{"title":"Prospective Evaluation of the Cardiovascular Effects of BRAF and MEK Inhibitors in Patients With Melanoma.","authors":"Claire Glen, Stephen J H Dobbin, Kenneth Mangion, Alasdair Henderson, Katriona Brooksbank, Caroline J Coats, Frederick H Epstein, Peter Kellman, Elaine Butler, Thomas R Jeffry Evans, Rob Jones, John McClure, Giles Roditi, Yun Yi Tan, Ashita Waterston, Paul Welsh, Mark C Petrie, Ninian N Lang","doi":"10.1016/j.jaccao.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jaccao.2025.08.006","url":null,"abstract":"<p><strong>Background: </strong>Rapidly accelerated fibrosarcoma B-type (BRAF) and MEK inhibitors have revolutionized outcomes for patients with BRAF-mutated melanoma. However, they are associated with cardiovascular adverse effects. The real-world incidence and risk factors for these effects are poorly described.</p><p><strong>Objectives: </strong>The aim of this study was to characterize the incidence and risk factors for BRAF inhibitor- and MEK inhibitor-associated hypertension and cancer therapy-related cardiac dysfunction (CTRCD) in a real-world setting.</p><p><strong>Methods: </strong>A prospective, longitudinal, cohort study was undertaken among patients with melanoma treated with BRAF and MEK inhibitors in a regional cancer network (March 2021 to March 2023). Baseline cardiotoxicity risk stratification was assessed using the European Society of Cardiology cardio-oncology guideline-recommended tool. Comprehensive cardiovascular assessment was performed at baseline and at 4, 12, and 24 weeks, including home and clinic blood pressure, echocardiography, stress perfusion cardiovascular magnetic resonance imaging and blood biomarkers. CTRCD was defined using International Cardio-Oncology Society definitions.</p><p><strong>Results: </strong>A total of 61 participants were enrolled. Twenty-eight participants (45.9%) developed hypertension and 45.9% developed CTRCD: 24 (85.7%) mild, 3 (10.7%) moderate, and 1 (3.6%) severe. All moderate or severe CTRCD was evident by 4 weeks and at least partially reversible. No patient at low baseline risk developed moderate or severe CTRCD. Patients with CTRCD had higher median baseline N-terminal pro-B-type natriuretic peptide compared with those without (109 pg/mL [Q1-Q3: 51-380 pg/mL] vs 54 pg/mL [Q1-Q3: 29-149 pg/mL]; P = 0.047). There were no robust associations between hypertension nor cardiovascular magnetic resonance imaging-derived myocardial or perfusion characteristics and incident CTRCD.</p><p><strong>Conclusions: </strong>BRAF inhibitor- and MEK inhibitor-associated hypertension and CTRCD are common. The present results reinforce the utility of baseline cardiotoxicity risk stratification, including assessment of N-terminal pro-B-type natriuretic peptide. Future guidelines should consider recommending early surveillance echocardiography for higher risk patients.</p>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Theodorus W. Kouwenberg MD , Elvira C. van Dalen MD, PhD , Renée L. Mulder PhD , Saro Armenian DO, MPH , Elizabeth A.M. Feijen PhD , Eric J. Chow MD, MPH , Helen Kosmidis MD, PhD , Britta J. Vormoor-Bürger MD, DrMed , Chikako Kiyotani MD, PhD , Paul C. Nathan MD, MSc , Livia Kapusta MD, PhD , Heynric B. Grotenhuis MD, PhD , Frederike K. Engels PhD , Arco J. Teske MD, PhD , Athanasios Tragiannidis MD, PhD , Martijn G. Slieker MD, PhD , Shuichi Ozono MD, PhD , Anju Nohria MD, MSc , Tomáš Sláma MD, PhD , Roderick Skinner MB, ChB , Annelies M.C. Mavinkurve-Groothuis MD, PhD
{"title":"IGHG Recommendations for Anthracycline and Anthraquinone Cardiac Dysfunction Equivalence Ratios After Childhood Cancer","authors":"Theodorus W. Kouwenberg MD , Elvira C. van Dalen MD, PhD , Renée L. Mulder PhD , Saro Armenian DO, MPH , Elizabeth A.M. Feijen PhD , Eric J. Chow MD, MPH , Helen Kosmidis MD, PhD , Britta J. Vormoor-Bürger MD, DrMed , Chikako Kiyotani MD, PhD , Paul C. Nathan MD, MSc , Livia Kapusta MD, PhD , Heynric B. Grotenhuis MD, PhD , Frederike K. Engels PhD , Arco J. Teske MD, PhD , Athanasios Tragiannidis MD, PhD , Martijn G. Slieker MD, PhD , Shuichi Ozono MD, PhD , Anju Nohria MD, MSc , Tomáš Sláma MD, PhD , Roderick Skinner MB, ChB , Annelies M.C. Mavinkurve-Groothuis MD, PhD","doi":"10.1016/j.jaccao.2025.05.009","DOIUrl":"10.1016/j.jaccao.2025.05.009","url":null,"abstract":"<div><div>Anthracycline and anthraquinone agents are major contributors to cancer therapy–related cardiac dysfunction in childhood cancer. However, evidence-based equivalence ratios for estimating individual risk have not been incorporated into international surveillance guidelines. The International Late Effects of Childhood Cancer Guideline Harmonization Group systematically reviewed the literature on equivalence ratios for doxorubicin, daunorubicin, epirubicin, idarubicin, and mitoxantrone. Based on available evidence, benefit–harm considerations, and expert consensus, the panel concluded that the risk of cardiac dysfunction is lower with daunorubicin and higher with mitoxantrone compared with doxorubicin (moderate-quality evidence; strong recommendation). The panel recommends using an approximate ratio of 0.6 to convert daunorubicin to a doxorubicin-equivalent dose and a ratio of 10.5 for mitoxantrone (low-quality evidence; moderate recommendation). No recommendation was made for epirubicin or idarubicin due to inconclusive evidence.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 6","pages":"Pages 683-690"},"PeriodicalIF":12.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah C. Hull MD, MBE , Reed Mszar MPH, MS , Robert J. Ostfeld MD, MSc , Leah M. Ferrucci PhD, MPH , Lorelei A. Mucci ScD, MPH , Edward Giovannucci MD, ScD , Stacy Loeb MD, MSc, PhD (Hon)
{"title":"Diet and Prevention of Cardiovascular Disease and Cancer","authors":"Sarah C. Hull MD, MBE , Reed Mszar MPH, MS , Robert J. Ostfeld MD, MSc , Leah M. Ferrucci PhD, MPH , Lorelei A. Mucci ScD, MPH , Edward Giovannucci MD, ScD , Stacy Loeb MD, MSc, PhD (Hon)","doi":"10.1016/j.jaccao.2025.07.008","DOIUrl":"10.1016/j.jaccao.2025.07.008","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) and cancer remain the leading causes of mortality in the United States, where poor diet has surpassed smoking as the leading risk factor for death, and life expectancy has hit a plateau as CVD mortality has stagnated over the past decade. Although the pathophysiology of CVD and cancer is complex and multifactorial, lifestyle factors including diet often contribute significantly to their pathogenesis. There is a wealth of observational data as well as emerging trial data supporting the benefits of a predominantly whole-food plant-based diet in the prevention of CVD and cancer. However, there is a need for implementation science to effectuate existing knowledge. Given the shortcomings of the standard American diet, characterized by excessive intake of red meat and ultraprocessed foods, while deficient in fiber and phytonutrients, it will be necessary to shift default patterns of eating to make healthy choices the path of least resistance.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 6","pages":"Pages 649-667"},"PeriodicalIF":12.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nazanin Aghel MD, MSc , Jeffrey Howard Lipton MD, PhD
{"title":"Cardiovascular Disease in Patients With Chronic Myeloid Leukemia","authors":"Nazanin Aghel MD, MSc , Jeffrey Howard Lipton MD, PhD","doi":"10.1016/j.jaccao.2025.06.007","DOIUrl":"10.1016/j.jaccao.2025.06.007","url":null,"abstract":"<div><div>Cardiovascular (CV) disease and risk factors are notably prevalent among patients with chronic myeloid leukemia (CML). The introduction of <em>BCR::ABL1</em> tyrosine kinase inhibitors has significantly transformed the treatment paradigm for CML. However, it is imperative to recognize that these therapeutic agents may lead to CV side effects. For instance, dasatinib has been associated with the development of pulmonary arterial hypertension, while nilotinib and ponatinib have been linked to various vascular complications. To accurately evaluate the incidence of CV events associated with CML treatment, systematic documentation of these occurrences in future clinical trials is essential. This approach will facilitate a deeper understanding of the CV implications of tyrosine kinase inhibitor therapy in patients with CML.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 6","pages":"Pages 668-682"},"PeriodicalIF":12.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachele Cagnazzo BS , Mario Stabile MD , Gabriele Zoppoli MD, PhD , Rudolf A. De Boer MD, PhD , Wouter C. Meijers MD, PhD , Peter van Der Meer MD, PhD , Pietro Ameri MD, PhD
{"title":"Mismatch Between Preclinical Cardio-Oncology and Clinical Oncology Research","authors":"Rachele Cagnazzo BS , Mario Stabile MD , Gabriele Zoppoli MD, PhD , Rudolf A. De Boer MD, PhD , Wouter C. Meijers MD, PhD , Peter van Der Meer MD, PhD , Pietro Ameri MD, PhD","doi":"10.1016/j.jaccao.2025.05.012","DOIUrl":"10.1016/j.jaccao.2025.05.012","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 6","pages":"Pages 770-773"},"PeriodicalIF":12.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacqueline B. Vo PhD, RN, MPH , Carolyn Brandt MPH , Kekoa Taparra MD, PhD, MPH , Cody Ramin PhD , Amy Berrington de González DPhil , Gretchen L. Gierach PhD, MPH , Wayne R. Lawrence DrPH , Jongeun Rhee ScD, MS , Meredith S. Shiels PhD , Lene H.S. Veiga PhD , Paloma R. Mitra BA , Jaimie Z. Shing PhD, MPH , Stella S. Yi PhD
{"title":"Disparities in Heart Disease Mortality Among Asian American and Pacific Islander Breast Cancer Survivors, 2000 to 2019","authors":"Jacqueline B. Vo PhD, RN, MPH , Carolyn Brandt MPH , Kekoa Taparra MD, PhD, MPH , Cody Ramin PhD , Amy Berrington de González DPhil , Gretchen L. Gierach PhD, MPH , Wayne R. Lawrence DrPH , Jongeun Rhee ScD, MS , Meredith S. Shiels PhD , Lene H.S. Veiga PhD , Paloma R. Mitra BA , Jaimie Z. Shing PhD, MPH , Stella S. Yi PhD","doi":"10.1016/j.jaccao.2025.08.003","DOIUrl":"10.1016/j.jaccao.2025.08.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 6","pages":"Pages 767-769"},"PeriodicalIF":12.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}