Medication guide for dose adjustment and management of cardiotoxicity and lipid metabolic adverse events of oral antineoplastic therapy.

The management of cardiotoxicity concerning the use of oral antineoplastic agents (OAAs) is a challenge for healthcare professionals. Our objective was to create a comprehensive medication management guide with dose adjustment recommendations on OAAs concerning cardiotoxic and lipid metabolic adverse events (AEs) to assist healthcare professionals when prescribing OAAs. A review of the available information on all dose adjustments necessary to safely prescribe and dispense OAAs concerning cardiotoxicity was conducted. In January 2023, we identified all OAAs authorized by the European Medicines Agency (EMA). For each drug, the latest summary of product characteristics (SPC) approved by the EMA and the tertiary data source Lexicomp In all, 93 different OAAs had been approved by the EMA and were reviewed. Among them, 51.6% have recognized cardiotoxic AEs and 10.8% can cause alterations in lipid metabolism. A total of 27 (29.0%) OAAs had specific recommendations regarding QT prolongation; 88.9% were listed in the SPC and 59.3% in Lexicomp More than half of the OAAs can produce cardiotoxic effects, with the most frequent being blood pressure alteration and QT interval prolongation with a non-depreciable incidence of LV dysfunction or thrombosis. Before starting the treatment, it is necessary to stratify baseline cardiovascular risk, plan a surveillance schedule, and consider referral to cardio-oncology units.

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Copyright © 2023 Ramos-Ruperez, Escudero-Vilaplana, Ruiz-Briones, Collado-Borrell, Villanueva-Bueno, Revuelta-Herrero, González-Haba, Garcia-Gonzalez, Ibañez-Garcia, Perez-Ramirez, Zatarain-Nicolás, Herranz and Sanjurjo.

Déclaration de conflit d'intérêts

VE-V received support for continuing education/advisory fees from Amgen, Astellas, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Merck Sharp & Dohme, Novartis, Roche, Sanofi, and Sobi outside the submitted work; RC-B received support for continuing education/advisory fees from Amgen, Astellas, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Merck Sharp & Dohme, Novartis, and Roche outside the submitted work. XG-G received support for continuing education/advisory fees from Amgen, Astellas, and Galápagos outside the submitted work. EZ-N received support for continuing education/advisory fees from AstraZeneca and Bayer outside the submitted work. AH received support for continuing education/advisory fees from Kern and Janssen outside the submitted work. MS received support for continuing education/advisory fees from Janssen, Roche, and Amgen outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.