Cardiotoxicity of anthracyclines: mechanisms and pharmacologic targets for prevention

Anthracyclines are a class of highly potent antitumour agents utilised against haematological and solid tumours. However, their use has been limited by their cardiotoxic adverse effects, which may lead to congestive heart failure. Such cardiac toxicity is directly related to the cumulative (total) dose of anthracyclines received. At the cellular level, many of the molecular mechanisms of anthracycline-induced cardiotoxicity remain obscure. The present review summarises the current knowledge on the production of anthracycline-induced reactive oxygen species, metabolite generation or cell death, and focuses on the molecules used to prevent anthracycline-induced cardiotoxicity.