Who should attend:

• Clinical faculty from the University of Pittsburgh School of Pharmacy
• Clinical staff pharmacists employed by the University of Pittsburgh Medical Center and deployed throughout the hospital campus in unit based roles and centrally in the department of pharmacy's main pharmacy
• Student pharmacy interns currently working within the department of pharmacy
• Certified Pharmacy Technicians

Upon successful completion of this continuing pharmacy education program, the participant should be able to:

• Explain the mechanisms of the different types of chemotherapy-induced cardiotoxicity (CIC).
• Identify patients at risk for CIC.
• Describe prevention strategies for patients at risk for CIC.
• Describe treatment strategies for patients with CIC.

Pharmacy Continuing Education Credits This program is sponsored by the University of Pittsburgh Center for Continuing Education in the Health Sciences. The University of Pittsburgh Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education. The assigned universal program number(s) is 0481-0000-19-089-H04-P.

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2. Banke A, Fosbøl EL, Ewertz M, et al. Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab. JACC: Heart Failure. 2019;7:217-224.
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7. Gradishar WJ, Anderson BO, Abraham J, et al. NCCN clinical practice guidelines in oncology: Breast Cancer NCCN Guidelines. 2019; 1.2019.
8. Gulati G, Heck SL, Ree AH, et al. Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): a 2 × 2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprolol. European heart journal. 2016;37:1671-1680.
9. Marty M, Espié M, Llombart A, et al. Multicenter randomized phase III study of the cardioprotective effect of dexrazoxane (Cardioxane) in advanced/metastatic breast cancer patients treated with anthracycline-based chemotherapy. Annals of oncology : official journal of the European Society for Medical Oncology. 2006;17:614-622.
10. Mohan N, Jiang J, Wu WJ. Implications of Autophagy and Oxidative Stress in Trastuzumab-Mediated Cardiac Toxicities. Austin pharmacology & pharmaceutics. 2017;2.

Abstract: While increased screening and advancements in treatment have improved survival for patients with many different types of cancer, drug toxicities remain a major limitation in oncologic therapy. Cardiotoxicity is a well-known side effect of a variety of chemotherapeutic agents. It has been thoroughly studied as an adverse effect of anthracyclines, and, more recently, has been described as an adverse effect of trastuzumab. Strategies for prevention of chemotherapy induced cardiotoxicity (CIC) include limiting cumulative anthracycline doses, utilizing medications commonly used in heart failure, and using dexrazoxane, which was approved for prevention of anthracycline induced cardiotoxicity in 2006. While some of these options have been proven to be effective at alleviating the decline in left ventricular ejection fraction (LVEF) seen in CIC, others provide little to no cardiac benefit. Strategies for treatment of CIC include waiting until the completion of chemotherapy for LVEF to recover on its own, or initiating standard heart failure treatment as recommended by the ACCF/AHA guidelines. This presentation serves to provide a review of some of the impactful literature regarding the use of these different approaches to the prevention and treatment of CIC.