PICARO: the Lower Normandy cardio-oncology network

Pharmacological management of adverse cardiovascular effects induced by drugs used in oncology.

A unique sector in France

The vital prognosis of cancer patients has greatly improved in recent years, transforming this once rapidly fatal disease into a chronic disease, even curable in some cases. However, oncologists have seen the emergence, alongside the emergence of new therapies (targeted oral therapies, immunotherapies, etc.), of new adverse effects, particularly cardiovascular ones: left ventricular dysfunction, rhythm disturbances and electrical abnormalities, myocardial ischemia, myocarditis, etc.

The Caen Normandy University Hospital, in conjunction with the OncoBasseNormandie Network offer a sector of “prevention and harmacological management of adverse CAR diac effects induced by drugs used in Oncology ” unique in France, the PICARO .

A regional vocation

PICARO is aimed at the whole of Western Normandy with coverage of Calvados, Manche and Orne initially, and a model which could extend to the entire Normandy region subsequently. .

Hospital and multidisciplinary care

Created in September 2017, the PICARO sector aims to:

to set up clearly identified patient pathways (patient pathway under anthracyclines, under targeted therapy, etc.),
to evaluate the possibility of introducing a potentially cardiotoxic anticancer treatment in a patient presenting cardiovascular risk factors or heart disease,
to care for patients suffering from cardiac complications induced by anticancer treatments, within the framework of dedicated hospital consultations, particularly in pharmacology and cardiology,
to ensure health monitoring by regularly disseminating emerging information from the sector (new toxicities, etc.) and by ensuring the completeness of pharmacovigilance declarations.

For this, PICARO brings together different specialties from Caen Normandy University Hospital:

clinical pharmacology,
pharmacovigilance,
the pharmaco-toxicology laboratory (drug dosages),
the heart failure unit,
the echocardiography laboratory,
the oncology federation (oncologists),
cardiac imaging,
vascular medicine.

A vocation for research

The PICARO sector also aims to develop research to better measure, anticipate and manage these adverse cardiac effects in order to improve the length and quality of patients' lives. The creation of a cohort of supported patients thus constitutes a first step towards the creation of a regional reference register. This research activity will also result in clinical cardioprotection trials and experimental studies.