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Cardiac toxicity: old and new issues in anti-cancer drugs

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Abstract

Although rare, cardiotoxicity is a significant complication of cancer treatment. The incidence and severity of cardiovascular side effects are dependent on the type of drugs used, dose and schedule employed, and age of patients, as well as the presence of coexisting cardiac diseases and previous mediastinal irradition. Classically, anthracyclines are among one of the most active agents in oncology, but their use is often hampered by their cumulative dose-limiting cardiotoxicity. In the past decade, combination therapy with new drugs such as taxanes of anti-EGFR, and Her-2 therapy as a single agent have also resulted in unexpected cardiotoxicity. Cardiac damage can be secondary to an alteration of cardiac rhythm, changes in blood pressure and ischaemia, and can also alter the ability of the heart to contract and/or relax. The clinical spectrum of these toxicities can range from subclinical abnormalities to being catastrophic, life-threatening and sometimes fatal. Knowledge of this toxicity can aid clinicians to choose the optimal and least toxic regimen suitable for an individual patient. In this work we present an exhaustive review of the cardiovascular side effects associated to new anticancer drugs, from new formulations of anthracyclines to tyrosine kinase inhibitors and monoclonal antibodies.

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Authors and Affiliations

  1. Oncology Department, La Paz Hospital, C/Embajadores 290 1A, Madrid, Spain

    María Sereno, Jorge Barriuso, Enrique Casado, Cristóbal Belda, Javier de Castro, Jaime Feliu & Manuel González-Barón

  2. Oncologia Medica 2, I.O.V. - I.R.C.C.S, Padova, Italy

    Antonella Brunello

  3. Thoracic Programme, L. Moffitt Cancer Centre and Institue Research, Tampa, FL, USA

    Alberto Chiappori

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  1. María Sereno
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  2. Antonella Brunello
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Sereno, M., Brunello, A., Chiappori, A. et al. Cardiac toxicity: old and new issues in anti-cancer drugs. Clin Transl Oncol 10, 35–46 (2008). https://doi.org/10.1007/s12094-008-0150-8

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