title: Mechanisms and Genetic Susceptibility of Chemotherapy-Induced Cardiotoxicity in Patients With Breast Cancer.
abstract: BACKGROUND
  Cardiotoxicity remains an important adverse reaction of chemotherapy used in the treatment of breast cancer, leading to increased morbidity and mortality.
  
  
  METHODS
  Anthracyclines, taxanes, and trastuzumab are the most commonly used cytotoxic drugs for the treatment of breast cancer. Cardiotoxicity may vary from asymptomatic forms to irreducible heart failure and death.
  Susceptibility for the occurrence of chemotherapy-induced cardiotoxicity and treatment resistance is multifactorial, with interindividual variability, determined by the interaction between genetic and phenotypic factors. Implementation of pharmacogenomic findings into clinical practice might be useful, to predict cardiotoxicity and to allow appropriate therapeutic measures.
  
  
  CONCLUSIONS
  This review will summarize the cellular mechanisms of chemotherapy-induced cardiotoxicity in breast cancer patients and will discuss the role of the genetic susceptibility for cardiac dysfunction.
authors.affiliation: 1University and Emergency Hospital, Bucharest, Romania; and 2Department of Cardiology, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Mihalcea
authors.forename: Maria
authors.initials: M
authors.lastname: Florescu
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000235:genetics*; D001943:Breast Neoplasms / Q000188:drug therapy*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000235:genetics*; D066126:Cardiotoxicity / Q000235:genetics; D000077143:Docetaxel; D004317:Doxorubicin / Q000009:adverse effects; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D020022:Genetic Predisposition to Disease; D006333:Heart Failure / Q000139:chemically induced / Q000235:genetics*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000235:genetics*; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000235:genetics*; D017239:Paclitaxel / Q000009:adverse effects; D047428:Protein Kinase Inhibitors / Q000009:adverse effects; D043823:Taxoids / Q000009:adverse effects; D019851:Thrombophilia / Q000139:chemically induced / Q000235:genetics*; D000068878:Trastuzumab / Q000009:adverse effects
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin; D004317:Doxorubicin; D000068878:Trastuzumab; D017239:Paclitaxel