Prevention and management of cardiotoxicity from antineoplastic therapy

Cardiotoxicity is a major side effect of various antineoplastic agents, particularly the anthracyclines. Recently, some of the newer drugs and biologic agents that have been introduced into cancer therapeutics also have been shown to have potential cardiotoxic effects. The spectrum of cardiac side effects varies with the antineoplastic agent, dose, and schedule used. Important risk factors associated with cardiotoxicity are cumulative dose, infusion schedule, and pre-existing cardiac disease. This review focuses on the various adverse cardiovascular events associated with antineoplastic agents, what to anticipate, how to recognize the toxicity, how to prevent and minimize the cardiac side effects, and how to manage the full-blown toxicity if and when it occurs.