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Molecular biomarkers in cardio-oncology: Where we stand and where we are heading
Panagiotis V S Vasileiou1, Gerasimos Siasos2, Vassilis G Gorgoulis1,3,4,5,6
1Molecular Carcinogenesis Group, Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Abstract:
Until recently, cardiotoxicity in the setting of a malignant disease was attributed solely to the detrimental effects of chemo- and/or radio-therapy to the heart. On this account, the focus was on the evaluation of well-established cardiac biomarkers for the early detection of myocardial damage. Currently, this view has been revised. Cardiotoxicity is not restricted to a single organ but instead affects the endothelium as a whole. Indeed, it has come into light that not only cancer therapy but also malignant cells per se can impair the cardiovascular system, through a paracrine and endocrine mode of action. Even more intriguingly, a clear interplay between molecular pathways involved in cancer and cardiovascular disease has become prevalent, suggesting a common nominator that governs the pathophysiology of these two entities. Taken together, our strategy in the quest of novel biomarkers in the emerging field of cardio-oncology should be critically reshaped.
Insights
Cardiotoxicity in cancer patients is now understood to involve more than just cancer treatments. Malignant cells themselves and shared molecular pathways contribute to cardiovascular damage, necessitating new biomarker strategies.
Area of Science:
- Cardio-oncology
- Cardiovascular Medicine
- Oncology
Background:
- Historically, cardiotoxicity in cancer patients was solely linked to chemotherapy and radiotherapy.
- Focus was on traditional cardiac biomarkers for detecting myocardial damage.
- This perspective has evolved significantly.
Purpose of the Study:
- To revise the understanding of cardiotoxicity in malignant diseases.
- To highlight the role of malignant cells and shared pathways in cardiovascular impairment.
- To advocate for a strategic shift in identifying novel biomarkers for cardio-oncology.
Main Methods:
- Review and synthesis of current research in cardio-oncology.
- Analysis of the impact of cancer therapies and malignant cells on the cardiovascular system.
- Exploration of molecular pathway interplay between cancer and cardiovascular disease.
Main Results:
- Cardiotoxicity affects the endothelium broadly, not just the heart.
- Malignant cells directly impair the cardiovascular system via paracrine and endocrine actions.
- A significant interplay exists between molecular pathways in cancer and cardiovascular disease.
Conclusions:
- The paradigm of cardiotoxicity in cancer is shifting beyond treatment effects.
- Shared molecular mechanisms link cancer and cardiovascular pathologies.
- Novel biomarker discovery strategies in cardio-oncology require critical reshaping.
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