Anthracycline-induced cardiotoxicity

Course, pathophysiology, prevention and management

Elly Barry, Jorge A. Alvarez, Rebecca E. Scully, Tracie L Miller, Steven E Lipshultz

Research output: Contribution to journalArticle

226 Citations (Scopus)

Abstract

Although effective anti-neoplastic agents, anthracyclines are limited by their well recognized and pervasive cardiotoxic effects. The incidence of late progressive cardiovascular disease in long-term survivors of cancer is established and may contribute to heart failure and death. To maximize the benefits of these drugs, a high-risk population has been identified and new strategies have been investigated to minimize toxic effects, including limiting the cumulative dose, controlling the rate of administration and using liposomal preparations and novel anthracycline analogues. Dexrazoxane also shows promise as a cardioprotectant during treatment. This paper reviews these strategies, as well as medications used to manage anthracycline-induced cardiotoxicity, and functional and biochemical means of monitoring cardiotoxicity, including echocardiography, radionuclide scans and biomarker analysis. The treatment of adult cancer survivors who have had anthracycline-related cardiotoxicity has not been systematically studied. Empirically, anthracycline-associated cardiac dysfunction is treated very similarly to other forms of heart failure. These treatments include avoiding additional cardiotoxic regimens, controlling hypertension, lifestyle changes, medications and heart transplantation.

Original languageEnglish
Pages (from-to)1039-1058
Number of pages20
JournalExpert Opinion on Pharmacotherapy
Volume8
Issue number8
DOIs
StatePublished - Jun 1 2007

Fingerprint

Anthracyclines
Survivors
Heart Failure
Dexrazoxane
Poisons
Heart Transplantation
Radioisotopes
Echocardiography
Life Style
Neoplasms
Cardiovascular Diseases
Therapeutics
Biomarkers
Cardiotoxicity
Hypertension
Incidence
Pharmaceutical Preparations
Population

Keywords

  • β-blockers
  • ACE inhibitors
  • Anthracyclines
  • Cardiotoxicity
  • Dexrazoxane
  • Doxorubicin epirubicin
  • Heart failure
  • Idarubicin
  • Liposomal doxorubicin
  • Mitoxantrone

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Anthracycline-induced cardiotoxicity : Course, pathophysiology, prevention and management. / Barry, Elly; Alvarez, Jorge A.; Scully, Rebecca E.; Miller, Tracie L; Lipshultz, Steven E.

In: Expert Opinion on Pharmacotherapy, Vol. 8, No. 8, 01.06.2007, p. 1039-1058.

Research output: Contribution to journalArticle

Barry, Elly ; Alvarez, Jorge A. ; Scully, Rebecca E. ; Miller, Tracie L ; Lipshultz, Steven E. / Anthracycline-induced cardiotoxicity : Course, pathophysiology, prevention and management. In: Expert Opinion on Pharmacotherapy. 2007 ; Vol. 8, No. 8. pp. 1039-1058.
@article{c5b5776523b64890acdcad743503a5af,
title = "Anthracycline-induced cardiotoxicity: Course, pathophysiology, prevention and management",
abstract = "Although effective anti-neoplastic agents, anthracyclines are limited by their well recognized and pervasive cardiotoxic effects. The incidence of late progressive cardiovascular disease in long-term survivors of cancer is established and may contribute to heart failure and death. To maximize the benefits of these drugs, a high-risk population has been identified and new strategies have been investigated to minimize toxic effects, including limiting the cumulative dose, controlling the rate of administration and using liposomal preparations and novel anthracycline analogues. Dexrazoxane also shows promise as a cardioprotectant during treatment. This paper reviews these strategies, as well as medications used to manage anthracycline-induced cardiotoxicity, and functional and biochemical means of monitoring cardiotoxicity, including echocardiography, radionuclide scans and biomarker analysis. The treatment of adult cancer survivors who have had anthracycline-related cardiotoxicity has not been systematically studied. Empirically, anthracycline-associated cardiac dysfunction is treated very similarly to other forms of heart failure. These treatments include avoiding additional cardiotoxic regimens, controlling hypertension, lifestyle changes, medications and heart transplantation.",
keywords = "β-blockers, ACE inhibitors, Anthracyclines, Cardiotoxicity, Dexrazoxane, Doxorubicin epirubicin, Heart failure, Idarubicin, Liposomal doxorubicin, Mitoxantrone",
author = "Elly Barry and Alvarez, {Jorge A.} and Scully, {Rebecca E.} and Miller, {Tracie L} and Lipshultz, {Steven E}",
year = "2007",
month = "6",
day = "1",
doi = "10.1517/14656566.8.8.1039",
language = "English",
volume = "8",
pages = "1039--1058",
journal = "Expert Opinion on Pharmacotherapy",
issn = "1465-6566",
publisher = "Informa Healthcare",
number = "8",

}

TY - JOUR

T1 - Anthracycline-induced cardiotoxicity

T2 - Course, pathophysiology, prevention and management

AU - Barry, Elly

AU - Alvarez, Jorge A.

AU - Scully, Rebecca E.

AU - Miller, Tracie L

AU - Lipshultz, Steven E

PY - 2007/6/1

Y1 - 2007/6/1

N2 - Although effective anti-neoplastic agents, anthracyclines are limited by their well recognized and pervasive cardiotoxic effects. The incidence of late progressive cardiovascular disease in long-term survivors of cancer is established and may contribute to heart failure and death. To maximize the benefits of these drugs, a high-risk population has been identified and new strategies have been investigated to minimize toxic effects, including limiting the cumulative dose, controlling the rate of administration and using liposomal preparations and novel anthracycline analogues. Dexrazoxane also shows promise as a cardioprotectant during treatment. This paper reviews these strategies, as well as medications used to manage anthracycline-induced cardiotoxicity, and functional and biochemical means of monitoring cardiotoxicity, including echocardiography, radionuclide scans and biomarker analysis. The treatment of adult cancer survivors who have had anthracycline-related cardiotoxicity has not been systematically studied. Empirically, anthracycline-associated cardiac dysfunction is treated very similarly to other forms of heart failure. These treatments include avoiding additional cardiotoxic regimens, controlling hypertension, lifestyle changes, medications and heart transplantation.

AB - Although effective anti-neoplastic agents, anthracyclines are limited by their well recognized and pervasive cardiotoxic effects. The incidence of late progressive cardiovascular disease in long-term survivors of cancer is established and may contribute to heart failure and death. To maximize the benefits of these drugs, a high-risk population has been identified and new strategies have been investigated to minimize toxic effects, including limiting the cumulative dose, controlling the rate of administration and using liposomal preparations and novel anthracycline analogues. Dexrazoxane also shows promise as a cardioprotectant during treatment. This paper reviews these strategies, as well as medications used to manage anthracycline-induced cardiotoxicity, and functional and biochemical means of monitoring cardiotoxicity, including echocardiography, radionuclide scans and biomarker analysis. The treatment of adult cancer survivors who have had anthracycline-related cardiotoxicity has not been systematically studied. Empirically, anthracycline-associated cardiac dysfunction is treated very similarly to other forms of heart failure. These treatments include avoiding additional cardiotoxic regimens, controlling hypertension, lifestyle changes, medications and heart transplantation.

KW - β-blockers

KW - ACE inhibitors

KW - Anthracyclines

KW - Cardiotoxicity

KW - Dexrazoxane

KW - Doxorubicin epirubicin

KW - Heart failure

KW - Idarubicin

KW - Liposomal doxorubicin

KW - Mitoxantrone

UR - http://www.scopus.com/inward/record.url?scp=34250641127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250641127&partnerID=8YFLogxK

U2 - 10.1517/14656566.8.8.1039

DO - 10.1517/14656566.8.8.1039

M3 - Article

VL - 8

SP - 1039

EP - 1058

JO - Expert Opinion on Pharmacotherapy

JF - Expert Opinion on Pharmacotherapy

SN - 1465-6566

IS - 8

ER -