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Journal Article Review Epublish 26 citations

PubMed: 39479333 DOI: 10.1016/j.jaccao.2024.07.016

Anthracycline Cardiotoxicity in Adult Cancer Patients: State-of-the-Art Review.

JACC CardioOncol 6(5):655-677

Authors: Massimiliano Camilli, Carlo Maria Cipolla, Susan Dent, Giorgio Minotti, Daniela Maria Cardinale

Affiliations

  • Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
  • Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Cardioncology Unit, Cardioncology and Second Opinion Division, European Institute of Oncology IRCCS, Milan, Italy.
  • Duke Cancer Institute, Duke University, Durham, North Carolina, USA.
  • Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, North Carolina, USA.
  • Università e Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Abstract

Since their introduction in the 1960s, anthracyclines have been a significant breakthrough in oncology, introducing dramatic changes in the treatment of solid and hematologic malignancies. Although new-generation targeted drugs and cellular therapies are revolutionizing contemporary oncology, anthracyclines remain the cornerstone of treatment for lymphomas, acute leukemias, and soft tissue sarcomas. However, their clinical application is limited by a dose-dependent cardiotoxicity that can reduce cardiac performance and eventually lead to overt heart failure. The field of cardio-oncology has emerged to safeguard the cardiovascular health of cancer patients receiving these therapies. It focuses on controlling risk factors, implementing preventive strategies, ensuring appropriate surveillance, and managing complications. This state-of-the-art review summarizes the current indications for anthracyclines in modern oncology, explores recent evidence on pathophysiology and epidemiology, and discusses advances in cardioprotection measures in the anthracycline-treated patient. Additionally, it highlights key clinical challenges and research gaps in this area.

MeSH

Heart Failure, Neoplasms, Biomarkers, Sarcoma, Cardiotoxicity, Anthracyclines, Diagnosis, Therapeutics

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