Chemotherapy-Induced Cardiotoxicity: A Comprehensive Review of Current Understanding and Future Directions

Area of Science:

• Cardio-oncology
• Oncology
• Cardiology

Background:

• Chemotherapy-induced cardiotoxicity (CIC) is a growing concern in cancer care, potentially limiting treatment efficacy and impacting patient survival.
• Mechanisms include oxidative stress, mitochondrial dysfunction, and inflammation, leading to cardiac muscle weakening.
• Improved cancer survival highlights the need for proactive management of cardiovascular complications.

Purpose of the Study:

• To review current understanding and future directions in chemotherapy-induced cardiotoxicity.
• To explore diagnostic biomarkers, imaging techniques, and therapeutic strategies for CIC.
• To emphasize the role of pharmacogenomics and preventive interventions in cardio-oncology.

Main Methods:

• Comprehensive review of published literature, clinical trials, and translational research on CIC.
• In-depth analysis of studies on anthracyclines and HER2 inhibitors.
• Focus on diagnostic advances, preventive measures, and emerging therapies for cardiac protection.

Main Results:

• CIC manifests as heart failure, arrhythmia, hypertension, ischemia, or thromboembolism, with risk factors including age, obesity, and genetics.
• Advanced diagnostics like troponins, natriuretic peptides, and echocardiography with GLS enable early detection.
• Preventive strategies (dose adjustment, liposomal formulations, dexrazoxane) and management with standard heart medications show benefits; experimental therapies offer promise for reversal.

Conclusions:

• CIC results from complex interactions between cancer, treatment, and patient vulnerability, necessitating a multidisciplinary oncology-cardiology approach.
• Lifestyle modifications and personalized care through genetic testing and molecular imaging are advancing cardio-oncology.
• Integrating precision medicine with preventive cardiology is key to minimizing cardiac injury while maximizing cancer treatment efficacy.