![]() ![]() The QT interval, representing ventricular repolarisation, is the principal surrogate marker to assess the arrhythmic risk of a drug. Ventricular Repolarisation Abnormality (QT Prolongation) Additionally, the mechanisms underlying arrhythmias in cancer patients are also driven by a complex interplay of both cancer and non-cancer treatment adverse effects along with electrolyte disturbances ( Figure 1). damage to the cardiac structure through ischaemia, inflammation or radiation therapy, with VA as a resulting phenomenon). the drug directly disrupting specific molecular pathways leading to development of arrhythmias) or secondary effects (i.e. Arrhythmic cardiotoxicity can either be because of primary effects (i.e. 8 Acute cardiotoxicities during treatment may preclude the administration of potentially life-saving cancer therapies, while chronic toxicities following treatment can impact long-term survival and quality of life. 3 In a recent evaluation of post-marketing safety communications for 125 cancer therapeutics approved by the Food and Drug Administration (FDA), arrhythmias were the most common reason for cardiovascular disease warnings (23.5%). 2–5, 8 The increasing age of the population with cancer, overlapping risk factors (hypertension, diabetes, hyperlipidaemia, inflammation and obesity) and history of cardiovascular diseases can predispose certain patients to a higher risk of developing arrhythmias during and after cancer treatment. 7Ĭancer-treatment-associated arrhythmia is a form of cardiotoxicity that is increasingly relevant and described in the literature, but poorly understood and characterised because of the heterogeneity of malignancies, multitude of cancer treatments, pre-existing cardiovascular risk factors and unclear arrhythmogenic mechanisms. 1, 6 Determining the arrhythmogenicity of cancer therapies can be challenging because the standard protocols of testing in healthy individuals during pre-drug approval cannot be implemented for chemotherapeutic agents. However, there has been a concerning uptrend of cardiovascular diseases, including ventricular arrhythmias (VA), in cancer patients. 1–5 Advances in cancer therapeutics and treatment strategies have resulted in improved cancer outcomes, leading to a growing cancer survivor population. No cash balance or cash flow is included in the calculation.Cardiovascular diseases and cancer pose a significant morbidity and mortality burden on a global scale. ![]() Please note all regulatory considerations regarding the presentation of fees must be taken into account. Backtested results are adjusted to reflect the reinvestment of dividends and other income and, except where otherwise indicated, are presented gross-of fees and do not include the effect of backtested transaction costs, management fees, performance fees or expenses, if applicable. Actual performance may differ significantly from backtested performance. Further, backtesting allows the security selection methodology to be adjusted until past returns are maximized. Since trades have not actually been executed, results may have under- or over-compensated for the impact, if any, of certain market factors, such as lack of liquidity, and may not reflect the impact that certain economic or market factors may have had on the decision-making process. Specifically, backtested results do not reflect actual trading or the effect of material economic and market factors on the decision-making process. Backtested performance is developed with the benefit of hindsight and has inherent limitations. This information is provided for illustrative purposes only. No representations and warranties are made as to the reasonableness of the assumptions. Certain assumptions have been made for modeling purposes and are unlikely to be realized. Changes in these assumptions may have a material impact on the backtested returns presented. General assumptions include: XYZ firm would have been able to purchase the securities recommended by the model and the markets were sufficiently liquid to permit all trading. Backtested results are calculated by the retroactive application of a model constructed on the basis of historical data and based on assumptions integral to the model which may or may not be testable and are subject to losses. The results reflect performance of a strategy not historically offered to investors and does not represent returns that any investor actually attained. Backtested performance is not an indicator of future actual results. Disclaimer: The TipRanks Smart Score performance is based on backtested results.
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