Adjuvant breast cancer treatments cardiotoxicity and modern methods of detection and prevention of cardiac complications

Abstract

The most common cancer diagnosis in female population is breast cancer, which affects every year about 2.0 million women worldwide. In recent years, significant progress has been made in oncological therapy, in systemic treatment, and in radiotherapy of breast cancer. Unfortunately, the improvement in the effectiveness of oncological treatment and prolonging patients' life span is associated with more frequent occurrence of organ complications, which are side effects of this treatment. Current recommendations suggest a periodic monitoring of the cardiovascular system in course of oncological treatment. The monitoring includes the assessment of occurrence of risk factors for cardiovascular diseases in combination with the evaluation of the left ventricular systolic function using echocardiography and electrocardiography as well as with the analysis of the concentration of cardiac biomarkers. The aim of this review was critical assessment of the breast cancer therapy cardiotoxicity and the analysis of methods its detections. The new cardio-specific biomarkers in serum, the development of modern imaging techniques (Global Longitudinal Strain and Three-Dimensional Left Ventricular Ejection Fraction) and genotyping, and especially their combined use, may become a useful tool for identifying patients at risk of developing cardiotoxicity, who require further cardiovascular monitoring or cardioprotective therapy.

Hydroxytyrosol Prevents Doxorubicin-Induced Oxidative Stress and Apoptosis in Cardiomyocytes

“…In order to prevent Dox-induced cardiotoxicity, several approaches have been suggested, including the use of new, less toxic Dox analogs, the application of high-sensitivity diagnostic procedures and cardioprotective supplemental therapies. Currently, early preventive treatment with additional cardioprotective agents is strongly recommended to counteract cardiotoxicity in patients undergoing oncological treatment [ 14 , 15 , 16 , 17 ]. Several therapeutic strategies to prevent Dox-induced cardiotoxicity have also been explored in preclinical studies.…”

Natural Taxanes: From Plant Composition to Human Pharmacology and Toxicity

“…Taxane-induced cardiac symptoms were detected in 16.6% of cases [ 117 ]. Myocardial toxicity is manifested by acute or subacute reversible bradycardia, which is typical for paclitaxel, AV blockades, prolongation of the QT interval, atrial or ventricular fibrillation and left ventricular dysfunction [ 117 , 118 ]. Congestive heart failure is less common compared to other antimicrotubular agents such as vinca alkaloids, while in monotherapy, the incidence of cardiotoxicity symptoms is lower compared to combinations.…”

Coronary Artery Disease and Cancer: Treatment and Prognosis Regarding Gender Differences

“…Antitumor antibiotic treatment with bleomycin for non-Hodgkin’s and Hodgkin’s lymphomas can cause angina, vasospasm, and ACS [ 56 ]. Cyclophosphamide, part of the CHOP treatment protocol (Cytoxan, hydroxyrubicin (Adriamycin), Oncovin (Vincristine), Prednisone (chemotherapy regimen), can cause left ventricular dysfunction, heart failure, myocarditis, pericarditis, arterial thrombosis, arrhythmias such as bradycardia, atrial fibrillation, and supraventricular tachycardia [ 79 ]. With rituximab and imatinib, decreased drug clearance in women should be noted [ 48 ].…”