Cancer Therapy-Induced Cardiotoxicity: A Narrative Review

Cancer therapy-induced cardiotoxicity (CTIC) is a significant clinical challenge in an era of rapidly evolving oncologic treatment. This comprehensive narrative review synthesizes evidence from clinical trials, meta-analyses, and guidelines to examine the definitions, mechanisms, offending agents, and preventative strategies for CTIC. Numerous therapeutic agents, beyond traditional chemotherapy, pose significant risks for cardiovascular events such as arrhythmias, hypertension, myocardial dysfunction, and vascular complications. These varied toxicity profiles necessitate individualized monitoring strategies. Given the rising cancer incidence and the proliferation of novel oral chemotherapeutic agents taken at home, non-oncology practitioners are increasingly likely to encounter patients with these cardiotoxicities. This creates a critical need for broader clinical familiarity with CTIC mechanisms and cardiovascular optimization strategies to mitigate long-term morbidity. Although existing evidence helps guide risk stratification, significant questions remain. Robust data from dedicated cardio-oncology trials, coupled with enhanced multidisciplinary collaboration, are urgently needed to define optimal prevention and treatment of CTIC for patients experiencing these serious adverse effects.