Methods of screening, monitoring and management of cardiac toxicity induced by chemotherapeutics

Abstract

Cardiac toxicity is one of the most common side effects of anticancer drugs. Cardiac toxicity results dysfunction of heart including hypotension, heart failure, and even cause death in extreme cases. The potential risk of cardiotoxicity is a huge concern in chemotherapeutics mediated cancer treatment. The individual with any pre-existing cardiac issues are excluded from clinical trials due to the potential risk of cardiotoxicity. Because of the potential cardiotoxicity, there is an emerging need for alternatives of some very potent anticancer drugs (doxorubicin/DOX, 5-fluorouracil/5FU, trastuzumab). While a patient is being treated with anticancer drugs, early blood screening, biomarker detection, and careful monitoring of cardiac functions are necessary to be able to avoid any irreversible cardiac damage. Therefore, early detection methodology to monitor cardiotoxicity in real-time, and a drug formulation that prevent interaction between drug and cardiac cell, seemingly have potential to mitigate the risk. In this review, we have summarized the cardiotoxicity of the most used anticancer drugs, their pathophysiology and some of the conventional and newer screening methods available to manage an individual patient in clinic. We have also incorporated our perspective on how a rationale designing of biomolecules can be used to overcome the cardiotoxicity generated chemotherapeutics.