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Current Heart Failure Reports
Published in: Current Heart Failure Reports 4/2018

01-08-2018 | Pharmacologic Therapy (W Tang, Section Editor)

Prevention of Cardiotoxicities With Traditional and Novel Chemotherapeutic Agents

Authors: Zarina Sharalaya, Patrick Collier

Published in: Current Heart Failure Reports | Issue 4/2018

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Abstract

Purpose of Review

This review will discuss strategies to prevent cardiotoxicity associated with chemotherapeutics. Forty years ago, investigators identified dose-dependent cardiotoxicity related to anthracycline-based regimens. Over recent decades, the development of more selective, mechanism-based chemotherapeutics has been associated with both on-target and off-target adverse cardiovascular sequelae.

Recent Findings

Strategies to prevent or attenuate cardiotoxicities include limitation of anthracycline dose, appropriate patient selection, referral/access to cardio-oncology programs, early recognition of cardiac side effects, active cardio-surveillance, cardio-protective medical therapy, treatment-specific concerns, and follow-up. The importance of accurate diagnosis of cardiotoxicity is important as false-positive testing may result in inappropriate holding or stopping potentially life-saving chemotherapy. Data to support use of cardio-protective medical therapy to prevent chemotherapy-related cardiotoxicity is modest at best, limited by marginal effect size, small patient numbers, and short follow-up.

Summary

The rapid growth in cardio-oncology clinics may facilitate larger multi-center randomized controlled trials in this area.
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Metadata
Title
Prevention of Cardiotoxicities With Traditional and Novel Chemotherapeutic Agents
Authors
Zarina Sharalaya
Patrick Collier
Publication date
01-08-2018
Publisher
Springer US
Published in
Current Heart Failure Reports / Issue 4/2018
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-018-0400-1

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