Cardiotoxicity of Non-Anthracycline Cancer Chemotherapy Agents.
Alexandros BriasoulisAngeliki ChasourakiAlexandros SianisNikolaos PanagiotouChristos KourekArgyrios NtalianisIoannis ParaskevaidisPublished in: Journal of cardiovascular development and disease (2022)
Throughout the last decades, newly developed chemotherapeutic agents and immunotherapies that target signaling pathways have provided patients with better prognoses, improved their quality of life and increased survival rates, thus converting cancer to a stable chronic disease. However, non-anthracycline cancer chemotherapy agents and immunotherapies including human epidermal growth factor receptor 2 (HER2) inhibitors, vascular endothelial growth factor (VEGF) inhibitors, Bcr-Abl tyrosine-kinase inhibitors (TKI), proteasome inhibitors, immune checkpoint inhibitors and chimeric antigen receptor T cells (CAR-T cells) may cause cardiovascular toxicity events and complications that usually interrupt the continuation of an appropriate treatment regimen, which induces life-threatening risks or leads to long-term morbidity. Heart failure, cardiac arrythmias and cardiomyopathies are the most common cardiovascular events related to cardiotoxicity due to chemotherapy. Each patient should be carefully assessed and monitored before, during and after the administration of chemotherapy, to address any predisposing risk factors and the new onset of cardiotoxicity manifestations early and treat them appropriately. The development of novel anticancer agents that cause minimal cardiovascular toxicity events or novel agents that ameliorate the adverse effects of the existing anticancer agents could drastically change the field of cardio-oncology. The aim of this narrative review is to demonstrate new knowledge regarding the screening and diagnosis of non-anthracycline-induced cardiotoxicity and to propose protective measures that could be performed in order to achieve the delivery of optimal care.
Keyphrases
- vascular endothelial growth factor
- tyrosine kinase
- epidermal growth factor receptor
- papillary thyroid
- cardiovascular events
- risk factors
- heart failure
- endothelial cells
- locally advanced
- healthcare
- squamous cell
- chronic myeloid leukemia
- palliative care
- advanced non small cell lung cancer
- left ventricular
- cardiovascular disease
- signaling pathway
- squamous cell carcinoma
- childhood cancer
- high glucose
- young adults
- atrial fibrillation
- type diabetes
- epithelial mesenchymal transition
- risk assessment
- rectal cancer
- cardiac resynchronization therapy
- quality improvement
- chemotherapy induced
- endoplasmic reticulum stress
- electronic health record
- drug induced