Cardiotoxicity of cancer therapy and current research efforts

Last month, we covered some of the most recent advances in cancer therapy (Mendes, 2020). However, a significant issue worthy of discussion relates to the adverse effects of cancer treatments. Research into developing therapies to target cancer cells without causing damage to other cells is ongoing, and comorbidities resulting from treatment are an important concern for long-term cancer survivors.

Cardiomyopathy or cardiac damage resulting from chemotherapy, radiation and anti-cancer signalling inhibitors is a major consideration (Myatt, 2015). Increases in life expectancy following anti-cancer therapy are countered by increased mortality from cardiac conditions, such as heart failure, myocardial infarction, arrhythmias, hypertension and thromboembolism (Bovelli et al, 2010). For example, quite alarmingly, in long-term survivors of Hodgkin's disease, myocardial infarction accounts for 25% of deaths (Curigliano et al, 2012).

Although chemotherapy is a highly effective cancer therapy, high doses can result in heart failure, which can be both debilitating and life-threatening (British Heart Foundation (BHF), 2020). To prevent this, cancer specialists often prescribe chemotherapy agents in lower doses, which are less effective at destroying cancer cells (BHF, 2020). There are approximately 50 chemotherapeutic agents; of these, the most commonly used is doxorubicin (BHF, 2020). According to the BHF (2020), among the small number of people who receive the maximum dose of doxorubicin, 7% will develop heart failure. Therefore, research is needed into potential ways to prevent the cardiotoxic effects of doxorubicin and other cardiotoxic cancer therapies (Suter and Ewer, 2013).