Oxidative stress and inflammation: determinants of anthracycline cardiotoxicity and possible therapeutic targets

Chemotherapy with anthracycline-based regimens remains a cornerstone of treatment of many solid and blood tumors but is associated with a significant risk of cardiotoxicity, which can manifest as asymptomatic left ventricular dysfunction or overt heart failure. These effects are typically dose-depen...

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Bibliographic Details
Published in:Heart failure reviews 2021-07, Vol.26 (4), p.881-890
Main Authors: Fabiani, Iacopo, Aimo, Alberto, Grigoratos, Chrysanthos, Castiglione, Vincenzo, Gentile, Francesco, Saccaro, Luigi F, Arzilli, Chiara, Cardinale, Daniela, Passino, Claudio, Emdin, Michele
Format: Article
Language:English
Subjects:
Antagonists
Anthracycline
Anthracyclines - adverse effects
Antibiotics, Antineoplastic - adverse effects
Cardiology
Cardiotoxicity
Chemotherapy
Congestive heart failure
Heart failure
Humans
Inflammation
Medicine
Medicine & Public Health
Oxidative Stress
Tumors
Ventricle
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Summary:Chemotherapy with anthracycline-based regimens remains a cornerstone of treatment of many solid and blood tumors but is associated with a significant risk of cardiotoxicity, which can manifest as asymptomatic left ventricular dysfunction or overt heart failure. These effects are typically dose-dependent and cumulative and may require appropriate screening strategies and cardioprotective therapies in order to minimize changes to anticancer regimens or even their discontinuation. Our current understanding of cardiac damage by anthracyclines includes a central role of oxidative stress and inflammation. The identification of these processes through circulating biomarkers or imaging techniques might then be helpful for early diagnosis and risk stratification. Furthermore, therapeutic strategies relieving oxidative stress and inflammation hold promise to prevent heart failure development or at least to mitigate cardiac damage, although further evidence is needed on their efficacy, either alone or as part of combination therapies with neurohormonal antagonists, which are the current adopted standard.
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-020-10063-9