Cardiotoxicity of cancer chemotherapy in clinical practice

Abstract

Several anticancer agents are associated with significant cardiotoxicity. The list of cardiotoxic cancer therapeutic agents includes anthracyclines, trastuzumab, alkylating agents, antimetabolites, which have been in use for decades; and recently introduced anticancer therapies such as tyrosine kinase inhibitors, angiogenesis inhibitors, checkpoint inhibitors and proteasome inhibitors. Cardiac imaging using echocardiography, nuclear imaging techniques, and magnetic resonance (MR) imaging can help in the early detection of chemotherapy-related cardiotoxicity. This can prevent the morbidity and mortality resulting from the cardiotoxicity of these agents. Further research is needed to improve our understanding of the underlying mechanism of their cardiotoxicity and to develop newer preventive and therapeutic strategies for chemotherapy related cardiotoxicity.

Keywords: 5-flurouracil; Anthracycline agents; cardiotoxicity; daunorubicin; doxorubicin; echocardiography; ejection fraction; global longitudinal strain imaging; heart failure; immune checkpoint inhibitors; pertuzumab; proteosome inhibitors; radionuclide ventriculography; trastuzumab; tyrosine kinase inhibitors.