The cardiotoxicity of chemotherapy. New prospects for an old problem

Background. Cardiotoxicity caused by chemotherapy, with its diverse early and late presentations, can hamper potentially curative or palliative treatments. The drugs most often linked to cardiotoxicity include anthracyclines, trastuzumab, 5-fluorouracil and taxanes, but some forms of cardiotoxicity have been described, more or less sporadically, for most antitumour agents. It is likely that the widespread use of the new biological target therapies will lead to the identification of other less known toxic effects. The available data on its incidence and clinical presentation, the pathogenetic mechanisms involved, the diagnosis, prevention and management of cardiac toxicity from chemotherapy are briefly reviewed. Conclusions. The identification of novel molecular targets will increase the number of drugs available for the treatment of neoplastic disease. It will be important to evaluate the side effects related to treatment, particularly in organs with a limited regenerative capability such as the heart. Further studies will therefore be necessary. (author)