Strategies to prevent anthracycline-induced cardiotoxicity in cancer survivors

Neha Bansal, M. Jacob Adams, Sarju Ganatra, Steven D. Colan, Sanjeev Aggarwal, Rudolf Steiner, Shahnawaz Amdani, Emma R. Lipshultz, Steven E. Lipshultz

Research output: Contribution to journalReview articlepeer-review

88 Scopus citations


Cancer diagnostics and therapies have improved steadily over the last few decades, markedly increasing life expectancy for patients at all ages. However, conventional and newer anti-neoplastic therapies can cause short- A nd long-term cardiotoxicity. The clinical implications of this cardiotoxicity become more important with the increasing use of cardiotoxic drugs. The implications are especially serious among patients predisposed to adverse cardiac effects, such as youth, the elderly, those with cardiovascular comorbidities, and those receiving additional chemotherapies or thoracic radiation. However, the optimal strategy for preventing and managing chemotherapy-induced cardiotoxicity remains unknown. The routine use of neurohormonal antagonists for cardioprotection is not currently justified, given the marginal benefits and associated adverse events, particularly with long-term use. The only United States Food and Drug Administration and European Medicines Agency approved treatment for preventing anthracycline-related cardiomyopathy is dexrazoxane. We advocate administering dexrazoxane during cancer treatment to limit the cardiotoxic effects of anthracycline chemotherapy.

Original languageEnglish (US)
Article number18
Issue number1
StatePublished - Dec 2 2019


  • ACE inhibitors
  • Anthracyclines
  • Beta-blockers
  • Cancer
  • Cardio-oncology
  • Cardiotoxicity
  • Pediatrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Oncology


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