A Retrospective & Prospective Observational Study on Cardiac Dysfunction by Anti- Cancer Drugs (Chemotherapy & Immunotherapy)

Sreemantula Divya*, Gouda Spandana¹, K.Chidhvi¹, Sarah Eliza¹, K.V.K.M.L Sugadri¹, Dr. Saadvik Raghuram.Y¹, Dr. Venu Talla¹, Dr. Saritha Jyostna Tangeda¹, Dr. Sujala Aakaram¹
Volume-12, Issue-1, January 2024, 4623 | Full article PDF
https://doi.org/10.30904/j.ajmps.2024.4623
Available online: Jan 15, 2024

A b s t r a c t
Introduction: Cancer therapy-related cardiac dysfunction (CTRCD) is one of the most feared and undesirable side effects of chemotherapy, occurring in approximately 10% of the patients. Cardio-oncology is an uprising field that has transformed the medical management of patients with cancer. It incorporates the prevention and treatment of cardiovascular dysfunctions related to cancer treatments, aiming to reduce cardiac adverse events among cancer survivors.Aim & Objectives: The aim of our study was to determine the incidence of CD by chemotherapy and immunotherapy and to evaluate echocardiographic and biomarker changes during the therapy.Methodology: It is a retrospective and prospective observational study conducted for a period of 6 months in a tertiary care hospital. The data was collected from the 55 patients with cancer who underwent treatment with doxorubicin, trastuzumab, pembrolizumab and nivolumab after approval of the protocol by the IEC of Medicover Hospitals. The statistical analysis was done by using SPSS software, V.22. (1) 1. SPSS I. IBM SPSS Statistics Version 22 Statistical Software: Core System Users’ Guide. SPSS Inc. 2014.Results and discussion: Majority of CD patients were females (75%) compared to men (25%) and most of them were advanced age >55years. The incidence of CD was found to be 12.5% with the administration of doxorubicin and trastuzumab. Most of the patients with CD were reported to have a past medical history of HTN i.e., 7 (87.5%) which is statistically significant (p <0.05). Few CD patients were reported to have a family history of cardiac disease, past history of DM, smoking which are clinically significant but statistically insignificant (p>0.05). A significant reduction in EF and GLS is seen in CD patients from 0-3 months and from 0-6months who are administered with doxorubicin and trastuzumab (p<0.05). CD patients who are administered with pembrolizumab had a statistically significant reduction in EF and GLS from baseline to 6months (p<0.05). Conclusion: The study concludes that patients administrated with chemotherapeutic drugs like Doxorubicin and Trastuzumab have a higher probability to develop CD than patients who are administrated with immunotherapeutic drugs such as Pembrolizumab and Nivolumab with an incidence of 12.5%. The incidence is seen more in patients that have co-existing conditions such as HTN & DM with females being more prone to it. GLS can be a useful and critical parameter in monitoring early CD in cancer patients. Careful monitoring is required during the treatment.
Keywords: Pembrolizumab,  Nivolumab, doxorubicin,  trastuzumab, CTRCD