Journal: Pharmacotherapy
This narrative review outlines current knowledge on cancer therapy–induced cardiotoxicity (CTIC), emphasizing that cardiotoxic risk now extends well beyond traditional cytotoxic chemotherapy to include many modern systemic agents and targeted therapies.
Key points:
- CTIC encompasses a broad spectrum of cardiovascular events: arrhythmias, hypertension, myocardial dysfunction/heart failure, and vascular complications.
- Different drug classes have distinct toxicity mechanisms and patterns, which require tailored surveillance approaches rather than a one-size-fits-all monitoring strategy.
- The increasing use of oral anticancer agents at home means primary care clinicians, hospitalists, cardiologists, and other non-oncology providers are more likely to encounter and manage CTIC.
- Current evidence from clinical trials, meta-analyses, and guidelines supports risk stratification and some preventative strategies, but major knowledge gaps remain, particularly regarding optimal monitoring, prophylaxis, and treatment.
- The authors stress the need for:
- Dedicated cardio-oncology clinical trials
- Better definition of prevention and management protocols
- Stronger multidisciplinary collaboration between oncology and cardiology teams to reduce long-term cardiovascular morbidity in cancer survivors.