HFA-ICOS Baseline Cardio-Oncology Risk Assessment for Anthracycline Chemotherapy
Stratifies cardiotoxicity risk in cancer patients scheduled to receive anthracycline-based chemotherapy.
This tool is specifically for evaluating cardiotoxicity risk of anthracycline therapy.
Other HFA-ICOS cardiotoxicity risk assessments are available for the following therapies:
Advice
- This tool is a decision-support aid and should be used alongside clinician judgment, patient preferences, specialist expertise, and current evidence-based guidelines/local protocols; results should not be the sole determinant of care.
- Total planned cumulative dose of anthracycline therapy should also be taken into account in a patient’s risk assessment (e.g., ≥250 mg/m2 of doxorubicin is also considered higher risk).
Management
- Low risk: Continue treatment with appropriate cardiovascular surveillance.
- Medium risk:
- Provide closer monitoring of cardiovascular health.
- Manage cardiovascular risk factors.
- Consider cardio-oncology or cardiology referral.
- High and very high risk:
- Discuss risks and benefits of proposed chemotherapy.
- Initiate closer cardiac monitoring.
- Refer for cardio-oncology or cardiology assessment to optimise risk factors and provide a personalised management plan.
- For more detailed guidance, please refer to the 2022 ESC guidelines.
Critical Actions
A referral to cardiology should be obtained for any patient who develops cardiotoxicity during therapy, regardless of initial risk.