PICARO: the Lower Normandy cardio-oncology network

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

A unique sector in France

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

The University Hospital of Caen Normandy, in conjunction with the OncoBasseNormandie Network , therefore wished to propose a pathway for "prevention and pharmacological management of adverse CAR diac effects induced by drugs used in Oncology " unique in France, the PICARO Pathway .

A regional focus

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

Hospital and multidisciplinary care

Created in September 2017, the PICARO program aims to:

to establish clearly identified patient pathways (pathway for patients on anthracyclines, on targeted therapy, etc.),
to assess the possibility of introducing a potentially cardiotoxic anticancer treatment in a patient with cardiovascular risk factors or heart disease,
to provide care for patients suffering from cardiac complications induced by cancer 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 reports.

To achieve this, PICARO brings together different specialties from the Caen Normandy University Hospital:

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

A research vocation

The PICARO network also aims to develop research to better measure, anticipate, and manage these adverse cardiac effects in order to improve patients' life expectancy and quality of life. The creation of a cohort of monitored patients is thus a first step towards establishing a regional reference registry. This research activity will also involve cardioprotection clinical trials and experimental studies.