Anthracycline Chemotherapy and Cardiotoxicity

Cardiovasc Drugs Ther. 2017 Feb;31(1):63-75. doi: 10.1007/s10557-016-6711-0.


Anthracycline chemotherapy maintains a prominent role in treating many forms of cancer. Cardiotoxic side effects limit their dosing and improved cancer outcomes expose the cancer survivor to increased cardiovascular morbidity and mortality. The basic mechanisms of cardiotoxicity may involve direct pathways for reactive oxygen species generation and topoisomerase 2 as well as other indirect pathways. Cardioprotective treatments are few and those that have been examined include renin angiotensin system blockade, beta blockers, or the iron chelator dexrazoxane. New treatments exploiting the ErbB or other novel pro-survival pathways, such as conditioning, are on the cardioprotection horizon. Even in the forthcoming era of targeted cancer therapies, the substantial proportion of today's anthracycline-treated cancer patients may become tomorrow's cardiac patient.

Keywords: Cancer anthracycline doxorubicin chemotherapy cardiotoxicity cardioprotection.

Publication types

  • Review

MeSH terms

  • Animals
  • Anthracyclines / adverse effects*
  • Antibiotics, Antineoplastic / therapeutic use*
  • Cardiotoxicity
  • Cardiovascular Agents / therapeutic use
  • Cytoprotection
  • Heart Diseases / chemically induced*
  • Heart Diseases / metabolism
  • Heart Diseases / physiopathology
  • Heart Diseases / prevention & control
  • Humans
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / metabolism
  • Myocytes, Cardiac / pathology
  • Risk Factors
  • Signal Transduction / drug effects
  • Time Factors
  • Troponin / metabolism


  • Anthracyclines
  • Antibiotics, Antineoplastic
  • Cardiovascular Agents
  • Troponin