Cancer drug related cardiotoxicity during breast cancer treatment.
BACKGROUND
Breast cancer (BC) is the most common cancer in women. Although therapeutic armamentarium like chemotherapy, endocrine and target agents have increased survival, cardiovascular side effects have been observed. A comprehensive risk assessment, early detection and management of cardiac adverse events is therefore needed.


METHODS
In this review we focus on cardiotoxicity data deriving from Phase III randomized trials, systematic reviews and meta-analysis in BC patients. We provide insight into advances that have been made in the molecular mechanisms, clinical presentation and management of such adverse event.


CONCLUSIONS
Despite the large number of data from Phase III trials about cardiac events incidence, there are poor evidences for detection, monitoring and management of cardiotoxicity during BC treatment. Future cardiotoxicity-oriented clinical cancer research can help to predict the risk of cardiac adverse events and improve patients' outcome. Multidisciplinary approach as well as integration of blood biomarkers with imaging will be desirable.
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Guido
G
Giordano
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Alessia
A
Spagnuolo
b Department of Biology , University of Naples, Federico II , Napoli , Italy.
Nunzio
N
Olivieri
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Claudia
C
Corbo
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Angelo
A
Campagna
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Ilaria
I
Spagnoletti
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Roberta Maria
RM
Pennacchio
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Serena
S
Campidoglio
c Duepartment of Science and Technology , University of Sannio , Benevento , Italy.
Massimo
M
Pancione
d Department of Surgery , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Luciano
L
Palladino
e Department of Cardiology , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Bruno
B
Villari
a Medical Oncology Unit , Ospedale Sacro Cuore di Gesù, Fatebenefratelli , Benevento , Italy.
Antonio
A
Febbraro
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D066126:Cardiotoxicity / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment / Q000379:methods
D000970:Antineoplastic Agents; D015415:Biomarkers
Anthracyclines; anti-HER2 agents; breast cancer; cardiotoxicity; type I and type II toxicity