Protecting against anthracycline-induced myocardial damage: a review of the most promising strategies.
Over the last 40 years, great progress has been made in treating childhood and adult cancers. However, this progress has come at an unforeseen cost, in the form of emerging long-term effects of anthracycline treatment. A major complication of anthracycline therapy is its adverse cardiovascular effects. If these cardiac complications could be reduced or prevented, higher doses of anthracyclines could potentially be used, thereby further increasing cancer cure rates. Moreover, as the incidence of cardiac toxicity resulting in congestive heart failure or even heart transplantation dropped, the quality and extent of life for cancer survivors would improve. We review the proposed mechanisms of action of anthracyclines and the consequences associated with anthracycline treatment in children and adults. We summarise the most promising current strategies to limit or prevent anthracycline-induced cardiotoxicity, as well as possible strategies to prevent existing cardiomyopathy from worsening.
Wouters
Karlijn A
KA
Division of Paediatrics, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands.
Kremer
Leontien C M
LC
Miller
Tracie L
TL
Herman
Eugene H
EH
Lipshultz
Steven E
SE
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006321:Heart / Q000187:drug effects*; D006333:Heart Failure / Q000139:chemically induced* / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000401:mortality; D015996:Survival Rate
D000806:Angiotensin-Converting Enzyme Inhibitors; D018943:Anthracyclines; D000970:Antineoplastic Agents; D000975:Antioxidants; D002316:Cardiotonic Agents