Abstract SP069: Strategies to reduce cardiac toxicity

Abstract

Abstract Approximately 60-70% of breast cancer (BC) patients receive radiation therapy (RT) as part of their care. Breast or chest wall RT improves locoregional control for BC and also improves BC survival in select populations. However, RT to the cardiac silhouette can be cardiotoxic and radiation induced cardiac toxicity (RIC) affects many breast cancer survivors. The likelihood of RIC is radiation dose dependent and can manifest in multiple forms including cardiovascular disease, heart failure, and/or pericarditis. The risk of cardiovascular disease among patients receiving RT for breast cancer increases linearly with mean heart dose exposure, with no minimum safe threshold. Prior studies have shown an increased risk of both major coronary events and heart failure within 5 years of RT among women with breast cancer, though the latency can be pronounced (10-20 years from exposure) and is further influenced by patient age at treatment as well as pre-existing cardiac risk factors. Therefore, the purpose of this talk is to: 1) discuss the nature and timing of RIC, including those patients most at risk of developing RIC, 2) review national and international cardiology-based guidelines for patient management after chest radiotherapy and 3) detail advances in cardiac sparing radiation techniques intended to reduce the risk of RIC. Ongoing research regarding novel detection and prevention strategies will be highlighted. Citation Format: R Jimenez. Strategies to reduce cardiac toxicity [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr SP069.