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Prevention of Cardiotoxicities With Traditional and Novel Chemotherapeutic Agents

  • Pharmacologic Therapy (W Tang, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review will discuss strategies to prevent cardiotoxicity associated with chemotherapeutics. Forty years ago, investigators identified dose-dependent cardiotoxicity related to anthracycline-based regimens. Over recent decades, the development of more selective, mechanism-based chemotherapeutics has been associated with both on-target and off-target adverse cardiovascular sequelae.

Recent Findings

Strategies to prevent or attenuate cardiotoxicities include limitation of anthracycline dose, appropriate patient selection, referral/access to cardio-oncology programs, early recognition of cardiac side effects, active cardio-surveillance, cardio-protective medical therapy, treatment-specific concerns, and follow-up. The importance of accurate diagnosis of cardiotoxicity is important as false-positive testing may result in inappropriate holding or stopping potentially life-saving chemotherapy. Data to support use of cardio-protective medical therapy to prevent chemotherapy-related cardiotoxicity is modest at best, limited by marginal effect size, small patient numbers, and short follow-up.

Summary

The rapid growth in cardio-oncology clinics may facilitate larger multi-center randomized controlled trials in this area.

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  1. Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH, 44195, USA

    Zarina Sharalaya & Patrick Collier

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Correspondence to Patrick Collier.

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Sharalaya, Z., Collier, P. Prevention of Cardiotoxicities With Traditional and Novel Chemotherapeutic Agents. Curr Heart Fail Rep 15, 260–269 (2018). https://doi.org/10.1007/s11897-018-0400-1

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