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Biotoxicity of Chemotherapy

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ALERT - Adverse Late Effects of Cancer Treatment

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

With successful treatment of many malignancies, long-term toxicities began to emerge and are becoming increasingly important in the growing number of cancer survivors. Research has begun to investigate management options to mitigate these chemotherapy-related toxicities without compromising the therapeutic outcomes. This chapter will discuss these late adverse effects based on organ system, including cardiotoxicity, pulmonary toxicity, nephrotoxicity, peripheral neuropathy, ototoxicity, reproductive toxicity, cognitive impairment, and risks of second malignant neoplasms. We will review the underlying pathophysiology of each of these long-term complications and will provide the most up-to-date evidence-based prevention, follow-up and monitoring guidelines. In the latter part of the chapter, we will review the current literatures regarding the molecular basis of germline genetic susceptibility to some of the late effects of chemotherapy, including peripheral neuropathy, ototoxicity and therapy-induced myeloid leukemia. This rapidly emerging field within cancer survivorship does not only provide invaluable insights and inform the development of therapeutic agents to target the underlying molecular pathway of these adverse effects, but it may also allow development of a risk-classification system that incorporates genetic markers to predict risks of chemotherapy-related side effects. The final part of this chapter will attempt to look at future research directions in the development of genetic markers as well as therapeutic agents to prevent or treat late-effects of chemotherapy.

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Authors and Affiliations

  1. James P Wilmot Cancer Center, University of Rochester Medical Center, Rochester, USA

    Chunkit Fung & Kishan J. Pandya

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  1. Chunkit Fung
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  2. Kishan J. Pandya
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  1. Dept. Radiation Oncology, University of Rochester Medical Center James P. Wilmot Cancer Ctr., Rochester, New York, USA

    Philip Rubin

  2. Department of Radiation Oncology, University of Rochester Medical Center James P. Wilmot Cancer Ctr., Rochester, New York, USA

    Louis S. Constine

  3. Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina, USA

    Lawrence B. Marks

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Fung, C., Pandya, K.J. (2014). Biotoxicity of Chemotherapy. In: Rubin, P., Constine, L., Marks, L. (eds) ALERT - Adverse Late Effects of Cancer Treatment. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72314-1_9

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