Overview of Oncology: Drug-Induced Cardiac Toxicity

Cancer medications can cause cardiac issues, which are difficult to treat in oncologic patients because of the risk of complications. In some cases, this may significantly impact their well-being and treatment outcomes. Overall, these complications fall under the term “drug induced cardiotoxicity”,...

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Main Authors: Nilima Rajpal Kundnani, Vincenzo Passini, Iulia Stefania Carlogea, Patrick Dumitrescu, Vlad Meche, Roxana Buzas, Daniel Marius Duda-Seiman
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/4/709
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author Nilima Rajpal Kundnani
Vincenzo Passini
Iulia Stefania Carlogea
Patrick Dumitrescu
Vlad Meche
Roxana Buzas
Daniel Marius Duda-Seiman
author_facet Nilima Rajpal Kundnani
Vincenzo Passini
Iulia Stefania Carlogea
Patrick Dumitrescu
Vlad Meche
Roxana Buzas
Daniel Marius Duda-Seiman
author_sort Nilima Rajpal Kundnani
collection DOAJ
description Cancer medications can cause cardiac issues, which are difficult to treat in oncologic patients because of the risk of complications. In some cases, this may significantly impact their well-being and treatment outcomes. Overall, these complications fall under the term “drug induced cardiotoxicity”, mainly due to chemotherapy drugs being specifically toxic to the heart, causing a decrease in the heart’s capacity to pump blood efficiently and leading to a reduction in the left ventricular ejection fraction (LVEF), and subsequently possibly leading to heart failure. Anthracyclines, alkylating agents, and targeted therapies for cancer hold the potential of causing harmful effects on the heart. The incidence of heart-related issues varies from patient to patient and depends on multiple factors, including the type of medication, dosage, duration of the treatment, and pre-existing heart conditions. The underlying mechanism leading to oncologic-drug-induced cardiovascular harmful effects is quite complex. One particular group of drugs, called anthracyclines, have garnered attention due to their impact on oxidative stress and their ability to cause direct harm to heart muscle cells. Reactive oxygen species (ROS) cause harm by inducing damage and programmed cell death in heart cells. Conventional biomarkers alone can only indicate some degree of damage that has already occurred and, therefore, early detection is key. Novel methods like genetic profiling are being developed to detect individuals at risk, prior to the onset of clinical symptoms. Key management strategies—including early detection, personalized medicine approaches, and the use of novel biomarkers—play a crucial role in mitigating cardiotoxicity and improving patient outcomes. Identification of generated genetic alterations and the association to an increased likelihood of cardiotoxicity will allow treatment in a more personalized approach, aiming at decreasing rates of cardiac events while maintaining high oncological efficacy. Oncology drug-induced cardiotoxicity is managed through a combination of preventive strategies and therapeutic interventions from the union of cardiac and oncological knowledge.
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spelling doaj-art-36afc1ac960241eeb1dce3aa695433ee2025-08-20T03:13:50ZengMDPI AGMedicina1010-660X1648-91442025-04-0161470910.3390/medicina61040709Overview of Oncology: Drug-Induced Cardiac ToxicityNilima Rajpal Kundnani0Vincenzo Passini1Iulia Stefania Carlogea2Patrick Dumitrescu3Vlad Meche4Roxana Buzas5Daniel Marius Duda-Seiman6University Clinic of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department VI—Cardiology, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, RomaniaFaculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, RomaniaUniversity Clinic of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department VI—Cardiology, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, RomaniaFaculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, RomaniaFaculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, Romania1st Medical Semiology, Internal Medicine, Department V, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, RomaniaUniversity Clinic of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department VI—Cardiology, “Victor Babes” University of Medicine and Pharmacy, 3000041 Timisoara, RomaniaCancer medications can cause cardiac issues, which are difficult to treat in oncologic patients because of the risk of complications. In some cases, this may significantly impact their well-being and treatment outcomes. Overall, these complications fall under the term “drug induced cardiotoxicity”, mainly due to chemotherapy drugs being specifically toxic to the heart, causing a decrease in the heart’s capacity to pump blood efficiently and leading to a reduction in the left ventricular ejection fraction (LVEF), and subsequently possibly leading to heart failure. Anthracyclines, alkylating agents, and targeted therapies for cancer hold the potential of causing harmful effects on the heart. The incidence of heart-related issues varies from patient to patient and depends on multiple factors, including the type of medication, dosage, duration of the treatment, and pre-existing heart conditions. The underlying mechanism leading to oncologic-drug-induced cardiovascular harmful effects is quite complex. One particular group of drugs, called anthracyclines, have garnered attention due to their impact on oxidative stress and their ability to cause direct harm to heart muscle cells. Reactive oxygen species (ROS) cause harm by inducing damage and programmed cell death in heart cells. Conventional biomarkers alone can only indicate some degree of damage that has already occurred and, therefore, early detection is key. Novel methods like genetic profiling are being developed to detect individuals at risk, prior to the onset of clinical symptoms. Key management strategies—including early detection, personalized medicine approaches, and the use of novel biomarkers—play a crucial role in mitigating cardiotoxicity and improving patient outcomes. Identification of generated genetic alterations and the association to an increased likelihood of cardiotoxicity will allow treatment in a more personalized approach, aiming at decreasing rates of cardiac events while maintaining high oncological efficacy. Oncology drug-induced cardiotoxicity is managed through a combination of preventive strategies and therapeutic interventions from the union of cardiac and oncological knowledge.https://www.mdpi.com/1648-9144/61/4/709cardiotoxicitychemotherapyradiotherapyanthracyclinesanti-HER2 receptor monoclonal antibody
spellingShingle Nilima Rajpal Kundnani
Vincenzo Passini
Iulia Stefania Carlogea
Patrick Dumitrescu
Vlad Meche
Roxana Buzas
Daniel Marius Duda-Seiman
Overview of Oncology: Drug-Induced Cardiac Toxicity
Medicina
cardiotoxicity
chemotherapy
radiotherapy
anthracyclines
anti-HER2 receptor monoclonal antibody
title Overview of Oncology: Drug-Induced Cardiac Toxicity
title_full Overview of Oncology: Drug-Induced Cardiac Toxicity
title_fullStr Overview of Oncology: Drug-Induced Cardiac Toxicity
title_full_unstemmed Overview of Oncology: Drug-Induced Cardiac Toxicity
title_short Overview of Oncology: Drug-Induced Cardiac Toxicity
title_sort overview of oncology drug induced cardiac toxicity
topic cardiotoxicity
chemotherapy
radiotherapy
anthracyclines
anti-HER2 receptor monoclonal antibody
url https://www.mdpi.com/1648-9144/61/4/709
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