title: A recommended practical approach to the management of anthracycline-based chemotherapy cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology.
abstract: Anthracyclines are the mainstay of treatment of a variety of haematological malignancies and solid tumours. Unfortunately, the clinical use of these drugs is limited by cumulative, dose-related cardiotoxicity which may ultimately lead to a severe and irreversible form of cardiomyopathy. Thus, there is an increasing need for close cooperation among cardiologists, oncologists and haemato-oncologists. As anthracyclines save lives, the logical goal of this cooperation, besides preventing or mitigating cardiotoxicity, is to promote an acceptable balance between the potential cardiac side effects and the vital benefit of anticancer treatment. This manuscript, which is specifically addressed to the cardiologist who has not accumulated much experience in the field of cancer therapy, focuses on several topics, that is old and new mechanisms of cardiac toxicity, late cardiac toxicity, the importance of overall risk assessment, the key role of a cardiology consult before starting cancer therapy, and the pros and cons of primary and secondary prevention programmes.
authors.affiliation: aClinic of Cardiovascular Diseases, IRCCS San Martino IST, Genoa bDivision of Cardiology, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione Giovanni Pascale' - IRCCS, Naples cDepartment of Medical Sciences 'Mario Aresu', University of Cagliari dInstitute of Cardiology, Center of Excellence on Aging, 'G. d'Annunzio' University, Chieti eCardiology Unit, University Hospital of Ferrara, Ferrara fDepartment of General Surgery and Medical-Surgery Specialties, University of Catania, Catania gChair and Division of Cardiology, University of Palermo, Palermo hDepartment of Clinical and Biological Sciences, University of Turin, Orbassano iU.O.C. Magnetic Resonance Imaging, Fondazione G. Monasterio C.N.R., Pisa jDepartment of Translational Medical Sciences, Federico II University, Naples kU.O.C. Cardiology Intensive Unit, A.O.U. Policlinico 'G. Martino', University of Messina, Messina, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Spallarossa
authors.forename: Nicola
authors.initials: N
authors.lastname: Maurea
authors.forename: Christian
authors.initials: C
authors.lastname: Cadeddu
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Madonna
authors.forename: Donato
authors.initials: D
authors.lastname: Mele
authors.forename: Ines
authors.initials: I
authors.lastname: Monte
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Pagliaro
authors.forename: Alessia
authors.initials: A
authors.lastname: Pepe
authors.forename: Carlo G
authors.initials: CG
authors.lastname: Tocchetti
authors.forename: Concetta
authors.initials: C
authors.lastname: Zito
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mercuro
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D000072096:Cardiologists / Q000193:education; D066126:Cardiotoxicity / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control*; D019468:Disease Management; D006801:Humans; D007558:Italy; D009369:Neoplasms / Q000188:drug therapy; D018570:Risk Assessment; D012955:Societies, Medical
chemical_list: D000970:Antineoplastic Agents