SPC365

Cardiovascular toxicity prediction in breast cancer patients: the HFA/ICOS risk tool in real-world practice

Session: SESSÃO DE POSTERS 56 - CARDIONCOLOGIA DE PONTA I
Speaker: Beatriz Vargas Andrade

Congress: CPC 2025
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.6 Cardio-Oncology
Session Type: Cartazes
FP Number: ---
Authors: Beatriz Vargas Andrade; Nuno Cotrim; Catarina Coelho; Rita Veiga; Mariana Saraiva; Vítor Martins

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Introduction:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Advances in cancer prevention and treatment have significantly improved breast cancer (BC) survival, but chemotherapy-related cardiac dysfunction (CTRCD) is a growing concern. The 2022 ESC Guidelines on Cardio-Oncology recommend baseline cardiovascular risk stratification using the risk assessment tools proposed by the Heart Failure Association (HFA) and the International Cardio-Oncology Society (ICOS) for patients scheduled to receive anthracyclines (AC) and anti-human epidermal growth factor receptor-2 (HER2) agents. However, its ability to predict severe CTRCD lacks real-life validation, particularly in the Portuguese population.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Purpose:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> To evaluate the clinical application of HFA/ICOS risk score in BC patients undergoing chemotherapy with AC or anti-HER2 agents and its utility in predicting the development of CTRCD in a Portuguese population.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> BC patients treated with AC or anti-HER2 agents and followed in Cardio-oncology&nbsp;consultation in a local portuguese hospital were retrospectively divided according to the HFA-ICOS risk proforma.&nbsp;The primary endpoint was moderate to severe CTRCD. All-cause and cardiovascular (CV) mortality were secondary endpoints.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Results:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> We included 65 pts (100% women; mean age 60 &plusmn; 10 years; 38% &ge;65 years).&nbsp;15 (23%) had metastatic disease. Regarding chemotherapy regimens, 45% were exposed to AC only, 10% to anti-HER2 only and 45% to AC plus anti-HER2.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">According to the HFA-ICOS tool, 22 pts (34%) were classified as low risk, 24 (37%) as moderate risk, 11 (17%) as high risk, and 8 (12%) as very high risk. Median follow-up was 36 months (interquartile range 23-70). 15 pts (23%) developed CTRCD: 14 (93%) moderate to severe, 9 (60%) symptomatic. 9 pts (14%) died, 2 by CV cause.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">A statistically significant association between very high basal CV risk and development of moderate to severe CTRCD was found (p 0.009; OR=8.9, 95% CI [1.8;43]).The same was verified for all-cause mortality (p 0.01; OR=10, 95% CI [1.9;54]) and CV mortality (p 0.01; OR=1.3, 95% CI [0.9;2]).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">This study supports the HFA/ICOS score&#39;s ability to predict moderate to severe CTRCD in breast cancer pts treated with AC or anti-HER2 agents, highlighting the importance of close monitoring, especially in very-high risk pts.</span></span></span></span></p>