Where research becomes treatment in real time

A study of the European Institute of Oncology just published in Circulation, the most prestigious scientific journal in the cardiovascular field, confirms the key role of cardiology to improve and extend the effectiveness of cancer treatments. A group of IEO doctors  and the Monzino Cardiology Center have found that the anthracycline cardiotoxicity - chemotherapy drugs used against many pediatric and adult cancers, particularly in breast and lymphoma  cancer treatments - is not irreversible.

"The anthracycline cardiotoxicity - explains Daniela Cardinale, director of the IEO Unit of Cardioncology and first author of the work - is a serious complication of cancer treatmenst that may weigh negatively on the prognosis of cancer patients regardless the tumor basic problem. Even today it is considered irreversible because it was deemed poorly responsive to cardiac drugs".

The prospective study, conducted at IEO lasted 19 years and involved 2,625 patients treated with anthracyclines. The incidence of cardiotoxicity was 9% and it is shown in almost all cases (98%) during the first 12 months from the end of the anticancer treatment. A close monitoring of cardiac function during this period enabled the diagnosis and early treatment of this form of heart disease, achieving the normalization of cardiac function in most cases (82%).

"These results - comments Cardinale Daniela - unhinge the ancient belief that the anthracycline cardiotoxicity is a fatal disease and bring into question the current classification that distinguishes cardiotoxicity in two different entities, early and late, depending on the time of onset of symptoms of heart failure (respectively within one year and one year after the end of chemotherapy). The cardiotoxicity seems to be a unique and continuous phenomenon, that starts with an asymptomatic cardiac dysfunction that if undiagnosed and untreated, may progress to the overt heart failure".

"There are no guidelines on cardiac monitoring of cancer patients based on real evidence - comments Carlo Cipolla, Director of the IEO Division of Cardiology, founder and first President of the International Cardioncology Society , as well as co-author of the publication. "This prospective study provides for the first time useful objective data for defining more precise indications, both for cardiologists and oncologists, in order to monitor cardiac patients undergoing cancer treatment."