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Cardio-Oncology pp 15–42Cite as

Cardiotoxicity of Anticancer Therapies

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Abstract

The optimal management of cardiotoxicity of patients treated with anticancer therapy involves a multidisciplinary, integrative clinical approach with participating general practitioners, cardiologists, and oncologists. Given the increasing number of cancer survivors, development of cardiotoxicity associated with anticancer therapy represents a complex clinical challenge and a major economic and health burden. Additionally, a large number of cancer survivors are at a higher risk of cardiotoxicity-related death than of cancer recurrence. Assessment and optimization of cardiac risk factors, awareness of potential cardiotoxicity of anticancer therapy, and close monitoring and appropriate treatment of patients may prevent cardiotoxicity and improve patient outcomes. The frequency of cardiotoxicity during cancer therapy varies by therapeutic class and agent as well by coexisting cardiac disease and concomitant use of other cardiotoxic agents. The use of cardioprotective agents (e.g., angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and beta-blockers) is critical in preventing and/or reversing cardiac injury caused by anticancer therapy. Cardiac impairment associated with anticancer therapy may require discontinuation of chemotherapeutic, targeted, or biologic anticancer agents. This chapter focuses on anticancer agents with potential cardiotoxicity. The incidence, type of cardiotoxicity, and pathophysiology of cardiotoxicity from published data including preclinical and clinical studies, case series, and case reports are summarized. The optimal preventive and therapeutic approaches based on available evidence as well as our expert opinion are discussed.

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Author information

Authors and Affiliations

  1. Division of Cancer Medicine, Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Rabih Said & Apostolia M. Tsimberidou

  2. Division of Oncology, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA

    Rabih Said

  3. Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA

    Myles Nickolich

  4. Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN, 37232, USA

    Daniel J. Lenihan

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  1. Rabih Said
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  2. Myles Nickolich
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  3. Daniel J. Lenihan
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  4. Apostolia M. Tsimberidou
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Correspondence to Apostolia M. Tsimberidou .

Editor information

Editors and Affiliations

  1. Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA

    Gretchen G. Kimmick

  2. Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Daniel J. Lenihan

  3. Maine Medical Center, Cardiovascular Institute, Portland, Maine, USA

    Douglas B. Sawyer

  4. Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA

    Erica L. Mayer

  5. Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York, USA

    Dawn L. Hershman

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Said, R., Nickolich, M., Lenihan, D.J., Tsimberidou, A.M. (2017). Cardiotoxicity of Anticancer Therapies. In: Kimmick, G., Lenihan, D., Sawyer, D., Mayer, E., Hershman, D. (eds) Cardio-Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-43096-6_2

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