Precision Treatment of Anthracycline-Induced Cardiotoxicity: An Updated Review

IF 3.8 2区医学 Q2 ONCOLOGY

Current Treatment Options in Oncology Pub Date : 2024-07-27 DOI:10.1007/s11864-024-01238-9

Ziyu Kuang, Yuansha Ge, Luchang Cao, Xinmiao Wang, Kexin Liu, Jiaxi Wang, Xiaojuan Zhu, Min Wu, Jie Li

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Abstract

Anthracycline (ANT)-induced cardiotoxicity (AIC) is a particularly prominent form of cancer therapy-related cardiovascular toxicity leading to the limitations of ANTs in clinical practice. Even though AIC has drawn particular attention, the best way to treat it is remaining unclear. Updates to AIC therapy have been made possible by recent developments in research on the underlying processes of AIC. We review the current molecular pathways leading to AIC: 1) oxidative stress (OS) including enzymatic-induced and other mechanisms; 2) topoisomerase; 3) inflammatory response; 4) cardiac progenitor cell damage; 5) epigenetic changes; 6) renin-angiotensin-aldosterone system (RAAS) dysregulation. And we systematically discuss current prevention and treatment strategies and novel pathogenesis-based therapies for AIC: 1) dose reduction and change; 2) altering drug delivery methods; 3) antioxidants, dexrezosen, statina, RAAS inhibitors, and hypoglycemic drugs; 4) miRNA, natural phytochemicals, mesenchymal stem cells, and cardiac progenitor cells. We also offer a fresh perspective on the management of AIC by outlining the current dilemmas and challenges associated with its prevention and treatment.

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蒽环类药物诱发心脏毒性的精准治疗：最新综述

蒽环类药物（ANT）诱发的心脏毒性（AIC）是癌症治疗相关心血管毒性的一种特别突出的形式，导致了蒽环类药物在临床实践中的局限性。尽管 AIC 已引起特别关注，但治疗它的最佳方法仍不明确。AIC 治疗的更新得益于对 AIC 潜在过程的最新研究进展。我们回顾了目前导致 AIC 的分子途径：1）氧化应激（OS），包括酶诱导和其他机制；2）拓扑异构酶；3）炎症反应；4）心脏祖细胞损伤；5）表观遗传学变化；6）肾素-血管紧张素-醛固酮系统（RAAS）失调。我们还系统地讨论了当前的预防和治疗策略以及基于发病机制的 AIC 新型疗法：1）减少和改变剂量；2）改变给药方法；3）抗氧化剂、右雷佐生、他汀类、RAAS 抑制剂和降糖药物；4）miRNA、天然植物化学物质、间充质干细胞和心脏祖细胞。我们还通过概述当前与 AIC 预防和治疗相关的困境和挑战，为 AIC 的管理提供了一个全新的视角。

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来源期刊

Current Treatment Options in Oncology ONCOLOGY-

CiteScore

7.10

自引率

0.00%

发文量

113

审稿时长

>12 weeks

期刊介绍： This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known oncologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.