Cardiac Toxicity of Cancer Chemotherapy

With the aging of the population, the number of patients diagnosed with cancer has grown significantly over the past few decades. In parallel, survival rates have improved due to the increased efficacy and tolerability of cancer treatments. As such, the acute and long-term toxicities of cancer therapies have become increasingly prominent as contributors to morbidity and mortality in cancer survivors. Cardiac toxicity can occur with a broad range of cancer treatments, from conventional cytotoxic agents to newer targeted and immune-based therapies. Common manifestations of chemotherapy-associated cardiotoxicity include asymptomatic left ventricular dysfunction, congestive heart failure, myocardial ischemia, myocarditis, QT prolongation, and arrhythmia. In this review, we will describe antitumor agents that have commonly been associated with an increased risk of cardiac toxicity, with an emphasis on clinical manifestations, underlying mechanisms, and cardioprotective strategies that can be implemented in this setting.