Chemotherapy induced cardiotoxicity is a well-known side effect of several cytotoxic drugs, especially of the anthracyclines
and may cause severe morbidity in surviving cancer patients. The mechanism of anthracycline induced cardiotoxicity, relatively
well established, seems to involve the free radicals formation and the apoptosis of myocytes. Prevention of cardiac toxicity can
be achieved by control of the cumulative dose. Furthermore, addition of the iron chelator to anthracycline therapy has
shown to be helpful. Other cytotoxic drugs such as the taxoids, 5-fluorouracil, cyclophosphamide and trastuzumab are associated
with cardiotoxicity as well, although little is known about the possible mechanisms. The pathophysiology of these adverse
effects is similarly heterogeneous and the identification of potential mechanisms is frequently difficult since the majority of cancer
patients is not only treated with multiple anti-cancer drugs but might also be exposed to potentially cardiotoxic radiation
therapy. Further research is warranted to understand the mechanism of chemotherapy induced cardiotoxicity and to develop
strategies to avoid this side effect.
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