Update on pathophysiology and preventive strategies of anthracycline-induced cardiotoxicity

Clin Exp Pharmacol Physiol. 2019 Mar;46(3):204-215. doi: 10.1111/1440-1681.13036. Epub 2018 Oct 30.

Abstract

Anthracycline chemotherapy has a prominent role in treating many forms of cancer. Unfortunately, cardiotoxic side effects represent a serious limitation to their use, with doxorubicin being the leading drug of the group. Indeed, anthracycline-induced cardiomyopathy is an important public health concern because it may not be detected for many years and remains a lifelong threat. Even after decades of investigation, neither the exact mode of action of anthracyclines nor the pathways leading to their side effect are fully understood. It is increasingly important to establish collaboration between oncologists and cardiologists to improve the management of cancer patient receiving anthracyclines. This article reviews the clinical course, pathogenesis, cardiac monitoring and new concepts in diagnosing and preventing anthracycline-induced cardiotoxicity.

Keywords: anthracycline; cancer; cardioprotection; cardiotoxicity; chemotherapy; doxorubicin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anthracyclines / adverse effects*
  • Antineoplastic Agents / adverse effects
  • Cardiotoxicity / etiology
  • Cardiotoxicity / metabolism
  • Cardiotoxicity / physiopathology*
  • Cardiotoxicity / prevention & control*
  • Humans

Substances

  • Anthracyclines
  • Antineoplastic Agents