Susan Faye Dent, MD

In a joint ASCO/ICOS (International Cardio-Oncology Society) session presented at the 2023 Global Cardio-Oncology Summit, Dr. Anita Arnold and Dr. Krishnan Bhaskaran discussed the importance of understanding the impact of cancer therapy on the cardiovascular health of women. Medical oncologist Susan Faye Dent, MD, posed this question for consideration: “More women are surviving a cancer diagnosis, but what is the impact of these therapies on cardiovascular morbidity and mortality?” Dr. Dent is Professor of Medicine at Duke University School of Medicine; Associate Director of Breast Cancer Clinical Research; and Co-Director of the Cardio-Oncology Program at Duke Health, Durham, North Carolina.

Dr. Dent continued: “Women receiving cancer therapy may be at increased risk of several cardiovascular toxicities…. These risks may be exacerbated by the presence of preexisting factors, such as hypertension, diabetes, and dyslipidemia. Although the focus by cancer providers and patients has been on reducing the risk for recurrent disease, emerging data suggest cardiovascular disease may be more of a threat; older women 5 years out from their breast cancer diagnosis have a higher risk of cardiovascular mortality than breast cancer. Health-care providers need to be aware of patients’ cardiovascular risk, ideally prior to initiation of cancer therapy, to aggressively manage these risk factors.”

Dr. Dent acknowledged that novel therapies, including immune checkpoint inhibitors, antibody-drug conjugates, and CDK4/6 inhibitors, have led to improved clinical outcomes in women with breast cancer. However, she asked, what are the short- and long-term impacts of these treatments on cardiovascular health? “The design of clinical trials evaluating novel cancer agents needs to include relevant cardiovascular endpoints, based on preclinical data, to permit adoption of preventive strategies and minimize potential cancer therapy–associated cardiovascular morbidity,” she concluded. 

DISCLOSURE: Dr. Dent has received honoraria from Novartis, Pfizer, Race Oncology, Bristol Myers Squibb, Myocardial Solutions, Gilead Sciences, and AstraZeneca.