Abstract

Anthracycline-based chemotherapy can result in the development of a cumulative and progressively developing cardiomyopathy. Doxorubicin is one of the most highly prescribed anthracyclines in the United States due to its broad spectrum of therapeutic efficacy. Interference with different mitochondrial processes is chief among the molecular and cellular determinants of doxorubicin cardiotoxicity, contributing to the development of cardiomyopathy. The present review provides the basis for the involvement of mitochondrial toxicity in the different functional hallmarks of anthracycline toxicity. Our objective is to understand the molecular determinants of a progressive deterioration of functional integrity of mitochondria that establishes a historic record of past drug treatments (mitochondrial memory) and renders the cancer patient susceptible to subsequent regimens of drug therapy. We focus on the involvement of doxorubicin-induced mitochondrial oxidative stress, disruption of mitochondrial oxidative phosphorylation, and permeability transition, contributing to altered metabolic and redox circuits in cardiac cells, ultimately culminating in disturbances of autophagy/mitophagy fluxes and increased apoptosis. We also suggest some possible pharmacological and nonpharmacological interventions that can reduce mitochondrial damage. Understanding the key role of mitochondria in doxorubicin-induced cardiomyopathy is essential to reduce the barriers that so dramatically limit the clinical success of this essential anticancer chemotherapy.

PMID: 32213135 [PubMed - in process]

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Radiation-Associated Pericardial Disease.

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Radiation-Associated Pericardial Disease.

Curr Cardiol Rep. 2019 07 27;21(9):97

Authors: Szpakowski N, Desai MY

Abstract

PURPOSE OF REVIEW: This review highlights the literature related to pericardial injury following radiation for oncologic diseases.

RECENT FINDINGS: Radiation-associated pericardial disease can have devastating consequences. Unfortunately, there is considerably less evidence regarding pericardial syndromes following thoracic radiation as compared to other cardiovascular outcomes. Pericardial complications of radiation may arise acutely or have an insidious onset several decades after treatment. Transthoracic echocardiography is the screening imaging modality of choice, while cardiac magnetic resonance imaging further characterizes the pericardium and guides treatment decision-making. Cardiac CT can be useful for assessing pericardial calcification. Ongoing efforts to lessen inadvertent cardiac injury are directed towards the revision of radiation techniques and protocols. As survival of mediastinal and thoracic malignancies continues to improve, radiation-associated pericardial disease is increasingly relevant. Though advances in radiation oncology demonstrate promise in curtailing cardiotoxicity, the long-term effects pertaining to pericardial complications remain to be seen.

PMID: 31352541 [PubMed - indexed for MEDLINE]

29 March 2020

14:40

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Strategies to Prevent Cardiovascular Toxicity in Breast Cancer: Is It Ready for Primetime?

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Strategies to Prevent Cardiovascular Toxicity in Breast Cancer: Is It Ready for Primetime?

J Clin Med. 2020 Mar 25;9(4):

Authors: Kikuchi R, Shah NP, Dent SF

Abstract

Cardio-oncology is an emerging field tasked with identifying and treating cancer therapy related cardiac dysfunction (e.g., cytotoxic agents, immunotherapies, radiation, and hormone therapies) and optimizing the cardiovascular health of cancer patients exposed to these agents. Novel cancer therapies have led to significant improvements in clinical outcomes for breast cancer patients. In this article, we review the current literature on assessing cardiovascular risk of breast cancer therapies and discuss strategies (including pharmacological and lifestyle interventions) to prevent cardiovascular toxicity.

PMID: 32218132 [PubMed - as supplied by publisher]

31 March 2020

13:48

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Efficacy and tolerability of mitoxantrone for neuromyelitis optica spectrum disorder: A systematic review.

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Efficacy and tolerability of mitoxantrone for neuromyelitis optica spectrum disorder: A systematic review.

J Neuroimmunol. 2019 07 15;332:126-134

Authors: Enriquez CAG, Espiritu AI, Pasco PMD