Anthracycline-Induced Cardiotoxicity: A Review of Pathophysiology, Diagnosis, and Treatment

TLDR: Progress made over the past two decades in understanding the molecular and genetic basis of anthracycline-induced cardiotoxicity is reviewed; detecting and monitoring myocardial dysfunction; using adjunct cardioprotectant therapies; and improvingCardioprotection with agents such as liposomal and pegylated doxorubicin are reviewed.

Abstract: Anthracyclines have been widely used in children and adults to treat hematologic malignancies, soft-tissue sarcomas, and solid tumors However, anthracyclines come with both short- and long-term cardiotoxic effects, ranging from occult changes in myocardial structure and function to severe cardiomyopathy and heart failure that may result in cardiac transplantation or death Here, we review the progress made over the past two decades in understanding the molecular and genetic basis of anthracycline-induced cardiotoxicity; detecting and monitoring myocardial dysfunction; using adjunct cardioprotectant therapies, such as dexrazoxane; and improving cardioprotection with agents such as liposomal and pegylated doxorubicin Despite this increased understanding, preventing drug-induced cardiotoxicity while maintaining oncologic efficacy to achieve the highest quality of life over a lifespan remain cornerstones of successful anthracycline chemotherapy during childhood