ToolsCalculators
HFA-ICOS Baseline Cardio-Oncology Risk Assessment for Combination RAF and MEK Inhibitors
Baseline cardiotoxicity risk stratification before combination RAF and MEK inhibitor therapy.
HFA-ICOS Baseline Cardio-Oncology Risk Assessment for Combination RAF and MEK Inhibitors
Existing heart failure or cardiomyopathy
Prior myocardial infarction or coronary artery bypass grafting
Stable angina
Severe valvular heart disease
Prior anthracycline exposure
Borderline LVEF 50-54%
Elevated baseline troponin
Elevated baseline BNP or NT-proBNP
Hypertension
Prior radiotherapy to the left chest or mediastinum
Arrhythmia
Age ≥65 years
Diabetes mellitus
Chronic kidney disease
Current smoker or significant smoking history
Obesity (BMI >30 kg/m²)
ResultLow risk
No or only a single medium-risk (1-point) factor is present. Routine baseline assessment is sufficient.
- Medium-risk points
- 0
- Overall risk category
- Low risk
When to use
- Baseline cardiovascular risk stratification before starting combination RAF and MEK inhibitor therapy in patients with cancer.
- Determining how intensively to monitor cardiac function during treatment.
Formula
Overall risk = Very high if any very-high-risk criterion is present; otherwise High if any high-risk criterion is present OR medium-risk points total ≥5; otherwise Moderate if medium-risk points total 2-4; otherwise Low (0 or 1 medium-risk point). Medium-risk items are weighted 1 or 2 points as specified.
Pearls and pitfalls
- Any single very-high-risk criterion overrides the point total and classifies the patient as very high risk.
- Risk category is intended to guide referral to cardio-oncology and the frequency of on-treatment cardiac imaging/biomarker surveillance, not to withhold effective cancer therapy.