Chemotherapy Induced Cardiotoxicity: Facts, Breakthroughs, and Challenges.

Abstract

Chemotherapy involves the use of one or more cytotoxic drugs to kill rapidly dividing malignant cells. One of the most promising fields of chemotherapy is the so-called targeted therapy, where a group of antibodies and small-molecule kinase inhibitors are designed to target key proteins involved in growth and proliferation pathways. Today, targeted therapeutics, such as Imatinib mesylate (Gleevec), have radically transformed the treatment of solid tumors and some blood malignancies. Unfortunately, the emerging chemotherapy associated cardiotoxicity posing unexpected challenges that may limit effective use of these novel drugs. Drug-induced cardiotoxicity is associated with cardiac cell death, cardiac dysfunction, and can lead to life threatening heart failure. The mechanisms underlying this cardiotoxicity remain poorly understood. In this review we discuss the cardiotoxicity of some of the major anticancer chemotherapy drugs, and summarize recent insights into the mechanisms implicated in cardiac cell death and survival.