Multiple Myeloma and Cardiovascular Comorbidities
Posted: Monday, April 22, 2019
Although new treatment agents for multiple myeloma are associated with cardiac complications, a recent report concluded that with careful assessment, monitoring, and prophylactic treatment, many of these cardiovascular toxicities may be prevented or identified early and managed. The review, published in Blood Cancer Journal, surveyed patients with multiple myeloma and discussed how a multidisciplinary approach along with improved guidelines may aid in handling cardiac risk factors for the best possible patient outcomes.
“To extend these treatments to all patients who would benefit from them, it is important that perceived cardiovascular risk does not form an inappropriate barrier to treatment,” Chris Plummer, PhD, FRCP, of Freeman Hospital, Newcastle upon Tyne, United Kingdom, and colleagues concluded.
The authors used data from summaries of product characteristics and three individual phase III trials that treated patients with relapsed or refractory multiple myeloma. Many treatments have been developed and approved recently, so long-term, real-world safety data are currently unavailable.
Recent pharmacotherapy advances in multiple myeloma, such as immunomodulators, proteasome inhibitors, histone deacetylase inhibitors, and monoclonal antibodies, have substantially improved progression-free survival and life expectancy. However, they also seem to increase the risk of cardiovascular and other adverse events. Hematologists/oncologists generally perform routine cardiovascular surveillance in patients under treatment for multiple myeloma, although a multidisciplinary solution involving cardiologists may optimize patient outcomes.
The authors concluded that current clinical guidelines represent the best expert opinion available. However, future trials should collect data that will increase our understanding of cardiac risks and adverse events associated with treatment agents and develop evidence-based guidelines for successful personalized treatment.
Disclosure: The study authors’ disclosure information may be found at nature.com.