title: Platinum-based compounds and risk for cardiovascular toxicity in the elderly: role of the antioxidants in chemoprevention.
abstract: Cancer in elderly patients is an increasingly common problem. Older patients have more co-morbidity, therefore the toxic effects of chemotherapy treatment are less tolerable compared to younger patients. Platinum-based compounds (PBCs) are commonly used cytotoxic agents in the treatment of several solid tumors; however, their application is still limited in elderly patients, due to the risks in cardiovascular toxicity. The increased risk for myocardial ischemia, stroke, and vascular thrombosis linked with PBCs treatment is mainly due to reactive oxygen species (ROS) production and the subsequent induction of oxidative stress and switch to a prothrombotic condition. Recently, studies have shown a different genetic susceptibility in cardiovascular toxicity induced by therapy with PBCs. Antioxidants, such as vitamin E, selenium, lycopene, melatonin, and resveratrol, have been implicated in cancer treatment by their property to suppress the oxidant injury. Resveratrol, especially, has been shown to increase the antineoplastic activity of cisplatin. In addition, resveratrol's ability to activate the sirtuin1 (SIRT1) pathway has been heavily implicated in the mechanisms controlling longevity and quality of life in the aged population. This article reviews the current state of treatment with PBCs and their associated risk for cardiovascular disease. It discusses the most powerful antioxidant supplementation options as a possible strategy to reduce the cardiovascular toxicity effects of chemotherapy in the elderly.
authors: Department of Laboratory Medicine & Advanced Biotechnologies, IRCCS San Raffaele Pisana, Rome, Italy.
authors: Patrizia
authors: P
authors: Ferroni
authors: David
authors: D
authors: Della-Morte
authors: Raffaele
authors: R
authors: Palmirotta
authors: Mark
authors: M
authors: McClendon
authors: Gianluca
authors: G
authors: Testa
authors: Pasquale
authors: P
authors: Abete
authors: Franco
authors: F
authors: Rengo
authors: Tatjana
authors: T
authors: Rundek
authors: Fiorella
authors: F
authors: Guadagni
authors: Mario
authors: M
authors: Roselli