46th issue of the Virtual Journal Club (VJC) is available online!

This is notification that the forty-sixth issue of the Virtual Journal Club (VJC) is available on the International Society of Oncology Pharmacy Practitioners (ISOPP) website. To access it, visit the Virtual Journal Club Surveys page or follow the direct link to the survey. 

"The utility of routine pre-chemotherapy with cardiac gated blood pool scan for patients at low risk of anthracycline toxicity"
Journal of Oncology Pharmacy Practice
Puey Ling Chia, K Chiang, R Synder and A Dowling
JOPP First Published 12 March 2017

It is well known that anthracyclines are cardiotoxic drugs. Many institutions do a baseline measure of left ventricular ejection fraction (LVEF) in every patient to receive an anthracycline. Is this necessary? This screening will cause a treatment delay and increase cost. Several studies have suggested patients omit this screening. This paper describes a single site, retrospective study over 3 years to determine whether baseline LVEF measurement impacted treatment decisions in their hospital. Their conclusion, that only 2 patients (1.1%) had LVEFs <50% and both had pre-existing cardiac risk factors and that both still received an anthracycline on clinician recommendation, leads them to recommend omitting a screening LVEF measure if the patient has no cardiac risk factors. What does your institution recommend?

Learning Objectives:

  1. Review the risk factors associated with development of anthracycline-induced cardiac toxicities;
  2. Understand the current recommendations on cardiovascular evaluation before anthracycline treatment by various guidelines;
  3. Review the process and rationale for baseline LVEF evaluation in all patients prior to anthracycline therapy and potentially modifying the need for LVEF evaluation according to risk profile;
  4. Review some of the other drugs that may also be associated with cardiac toxities; and
  5. Review the suggested monitoring scheme for patients on anthracycline therapy.