title: Cardiotoxicity of systemic agents used in breast cancer.
abstract: Several breast cancer therapies can lead to cardiovascular toxicity: drugs such anthracyclines can cause permanent damage, anti-HER2 agents may cause transitory and reversible cardiac dysfunction and others, such as those used in endocrine therapy, primarily disturb lipid metabolism. Considering the seriousness of these complications, trials are now being conducted to address cardiotoxicity associated with new drugs; however, to fully understand their toxicity profiles, longer follow-up is needed. In this review, we compile the information available about cardiac toxicity related to well-established systemic breast cancer treatments, as well as newer drugs, including antiangiogenics, mTOR inhibitors and novel anti-HER2 agents. We also describe current and next generation cardiac biomarkers and functional tests that can optimize treatment and reduce and prevent the incidence of treatment-related cardiotoxicity.
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Felipe
authors.initials: F
authors.lastname: Ades
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Zardavas
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Ana Catarina
authors.initials: AC
authors.lastname: Pinto
authors.affiliation: Division of Early Drug Development for Innovative Therapies, Istituto Europeo di Oncologia, Via Ripamonti 435, 20133 Milano, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Criscitiello
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Aftimos
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: evandro.azambuja@bordet.be.
authors.forename: Evandro
authors.initials: E
authors.lastname: de Azambuja
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects; D018943:Anthracyclines / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D066126:Cardiotoxicity; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced*; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D017202:Myocardial Ischemia / Q000139:chemically induced; D000068878:Trastuzumab
chemical_list: D020533:Angiogenesis Inhibitors; D018943:Anthracyclines; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D000068878:Trastuzumab
keywords: Anti-HER2 agents; Biomarkers; Breast cancer; Cardiotoxicity; Chemotherapy; Endocrine therapy