Title:Cardiotoxicity of Biological Therapies in Cancer Patients: An In-depth
Review
Volume: 19
Issue: 3
Author(s): Luai Madanat*, Ruby Gupta, Paul Weber, Navneet Kumar, Rohit Chandra, Hycienth Ahaneku, Yatharth Bansal, Joseph Anderson, Abhay Bilolikar and Ishmael Jaiyesimi
Affiliation:
- Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
Keywords:
Cardiotoxicity, anticancer drugs, targeted therapies, biological therapies, immune checkpoint inhibitors, cardiooncology.
Abstract: Cardiotoxicity from chemotherapy regimens has been long reported. However, the understanding
of cardiac side effects of biological therapies is rapidly evolving. With cancer patients
achieving higher life expectancy due to the use of personalized medicine and novel targeted anticancer
agents, the occurrence of cardiotoxicity is becoming more significant. Novel biological
therapies include anti-HER2 antibodies, tyrosine kinase inhibitors, bruton kinase inhibitors, antivascular
endothelial growth factors, proteasome inhibitors, immunomodulator drugs, and immune
checkpoint inhibitors. Potential cardiovascular toxicities linked to these anticancer agents include
hypertension, arrhythmias, QT prolongation, myocardial ischemia and infarction, left ventricular
dysfunction, congestive heart failure, and thromboembolism. Cardiac biomarkers, electrocardiography,
echocardiography and magnetic resonance imaging are common diagnostic modalities used
for early detection of these complications and timely intervention. This review discusses the various
types of cardiotoxicities caused by novel anticancer biologic agents, their molecular and pathophysiological
mechanisms, risk factors, and diagnostic and management strategies that can be
used to prevent, minimize, and treat them.