Cardiotoxicity of Chemotherapeutic Drugs: An Update and Future Perspectives

Abstract

:Rapid advancements in oncological treatments over the past few decades have led to a significant improvement in cancer outcomes. Chemotherapeutic agents play a pivotal role in cancer treatment, with almost one-third of patients receiving them during their cancer treatment in the United Kingdom. The success of chemotherapeutic drugs has, however, resulted in an increasing incidence of cardiovascular side effects and complications. The most common cardiac manifestation is the development of cardiotoxicity, defined as the development of left ventricular systolic dysfunction, after treatment. This article provides an up-to-date review of the commonly used chemotherapeutic agents that cause cardiotoxicity and discusses current treatment options and evidence gaps.

Clinical characterization and natural history of chemotherapy‐induced dilated cardiomyopathy

“…Similarly, in patients with early evidence of cardiotoxicity due to high dose anthracycline, treatment with enalapril was able to reduce the incidence of overt cardiac dysfunction 27 . Similarly, beta‐blocker and mineralocorticoid receptor antagonists are able to slow the progression of cardiotoxicity and perhaps improve cardiac outcomes in these patients 28 …”

“…27 Similarly, beta-blocker and mineralocorticoid receptor antagonists are able to slow the progression of cardiotoxicity and perhaps improve cardiac outcomes in these patients. 28 Finally, the use of biomarkers may be of interest as they showed relevant clinical implications in different settings. 29,30 Of note, CI-DCM patients had different distribution between sexes, with a higher proportion of affected women.…”

Multimodality imaging for cardiotoxicity: state of the art and future perspectives

“…Cumulative effects and complex interaction between genetic background and environmental factors may also contribute in this setting as also described in other phenotypes of cardiac dysfunction. [3][4][5][6] To maximize the life-prolonging effect of anticancer treatment and to avoid significant cardiovascular side effects, a close dialog and collaboration between oncologist and cardiologist is essential in this setting. Indeed, it enables prompt recognition of cardiac toxicity, reconsideration of types of cancer therapy and/or guides decision-making related to initiation of cardioprotective medications.…”

“…Cumulative effects and complex interaction between genetic background and environmental factors may also contribute in this setting as also described in other phenotypes of cardiac dysfunction. 3–6…”

Cardiovascular complications of anti-cancer therapy: a developing storm in medicine

“…Burashnikov 10 describes the available information on cancer drug–induced atrial fibrillation and underlying cellular mechanisms of this adverse effect. Bannister et al 11 reviewed cardiotoxicities caused by chemotherapeutic agents and their treatment, focusing on the left ventricular systolic dysfunction, the most commonly encountered cancer therapy–mediated cardiotoxicity. Artico et al 12 summarized the available information on the detection of cancer therapy–induced or aggravated cardiac structural abnormalities by multiple imaging technologies.…”