Interactions between cardiology and oncology drugs in precision cardio-oncology

Clin Sci (Lond). 2021 Jun 11;135(11):1333-1351. doi: 10.1042/CS20200309.

Abstract

Recent advances in treatment have transformed the management of cancer. Despite these advances, cardiovascular disease remains a leading cause of death in cancer survivors. Cardio-oncology has recently evolved as a subspecialty to prevent, diagnose, and manage cardiovascular side effects of antineoplastic therapy. An emphasis on optimal management of comorbidities and close attention to drug interactions are important in cardio-oncologic care. With interdisciplinary collaboration among oncologists, cardiologists, and pharmacists, there is potential to prevent and reduce drug-related toxicities of treatments. The cytochrome P450 (CYP450) family of enzymes and the P-glycoprotein (P-g) transporter play a crucial role in drug metabolism and drug resistance. Here we discuss the role of CYP450 and P-g in drug interactions in the field of cardio-oncology, provide an overview of the cardiotoxicity of a spectrum of cancer agents, highlight the role of precision medicine, and encourage a multidisciplinary treatment approach for patients with cancer.

Keywords: Cardio-Oncology; Drug Interactions; cancer; cardiovascular disease; cyp450; p-glycoprotein.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Cardiotoxicity / drug therapy*
  • Cardiovascular Diseases / drug therapy*
  • Female
  • Humans
  • Medical Oncology
  • Neoplasms / drug therapy*
  • Precision Medicine* / methods

Substances

  • Antineoplastic Agents