Anthracycline-Induced Cardiotoxicity: Causes, Mechanisms, and Prevention
Abstract
Doxorubicin is an anthracycline and one of the more effective chemotherapy agents used in the treatment of children, adolescents, and adults with osteosarcoma. Despite its effectiveness, cardiotoxicity is a major late effect that compromises the survival and quality of life of survivors of this and other cancers. Cardiotoxicity is the inability of the heart to pump blood through the body effectively. Doxorubicin-induced cardiotoxicity is dose dependent. Additionally, the age of the patients plays a role in susceptibility with younger patients having a greater risk for cardiotoxicity and heart failure years after treatment is complete. The exact mechanism(s) responsible for doxorubicin-induced cardiotoxicity is poorly understood, and further research needs to be done to elucidate the mechanisms. This chapter summarizes the identified mechanisms that may play a role in anthracycline-induced cardiotoxicity. We will also summarize the types of cardiomyopathies that have been described in survivors treated with doxorubicin and the current recommendations for monitoring survivor for the development of cardiomyopathies. Included will be the important search for defining early biomarkers to identify patients and survivors at risk. Finally, we will summarize some of the interventions proposed for decreasing anthracycline-induced cardiotoxicity.
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The cumulative anthracycline dose is a major risk factor for severe cardiomyopathy development, but young age at treatment, female sex, peak drug exposure and additional stress to the heart have also been implicated.
“The cumulative anthracycline dose is a major risk factor for severe cardiomyopathy development but young age at treatment, female sex, peak drug exposure and additional stress to the heart have also been implicated 161,162,163 .”
From Osteosarcoma (2022) · cites this paper as [162]
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- Authors
- Bhagat, A., & Kleinerman, E. S.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Bhagat, Anchit
- Venue
- Advances in Experimental Medicine and Biology
- Publisher
- Springer International Publishing
- Published
- 2020
- Volume
- 1257
- Pages
- 181-192
- ISSN
- 0065-2598 (ISSN-L)
- 2214-8019
- OpenAlex
- W3032582171
- Cited by
- 208
- References
- 35
- Citations by year
- 2026: 19 · 2025: 34 · 2024: 44 · 2023: 48 · 2022: 48 · 2021: 13 · 2020: 2
- FWCI
- 138.08
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Advances in experimental medicine and biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- anthracycline cardiotoxicity, doxorubicin, cardiomyopathy, heart failure, osteosarcoma, cancer survivors, cardiotoxicity mechanisms, cardiotoxicity biomarkers, cardiotoxicity prevention, cardiotoxicity monitoring
- MeSH terms
- Antibiotics, Antineoplastic, Humans, Neoplasms, Quality of Life, Osteosarcoma, Anthracyclines, Cardiotoxicity
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