A bench to bedside perspective on anthracycline chemotherapy-mediated cardiovascular dysfunction: challenges and opportunities. A symposium review

J Appl Physiol (1985). 2022 Dec 1;133(6):1415-1429. doi: 10.1152/japplphysiol.00471.2022. Epub 2022 Oct 27.

Abstract

Cardiovascular diseases (CVD) are the leading cause of death worldwide and the risk of developing CVD is markedly increased following anthracycline chemotherapy treatment. Anthracyclines are an essential component of the cancer treatment regimen used for common forms of cancer in male and female children, adolescents, young adults, and older adults. Increased CVD risk with anthracyclines occurs, in part, due to vascular dysfunction-impaired endothelial function and arterial stiffening. These features of vascular dysfunction also play a major role in other common disorders observed following anthracycline treatment, including chronic kidney disease, dementia, and exercise intolerance. However, the mechanisms by which anthracycline chemotherapy induces and sustains vascular dysfunction are incompletely understood. This budding area of biomedical research is termed cardio-oncology, which presents the unique opportunity for collaboration between physicians and basic scientists. This symposium, presented at Experimental Biology 2022, provided a timely update on this important biomedical research topic. The speakers presented observations made at levels from cells to mice to humans treated with anthracycline chemotherapeutic agents using an array of translational research approaches. The speaker panel included a diverse mix of female and male investigators and unique insight from a cardio-oncology physician-scientist. Particular emphasis was placed on challenges and opportunities in this field as well as mechanisms that could be viewed as therapeutic targets leading to novel treatment strategies.

Keywords: arterial stiffness; cardio-oncology; clinical care; endothelial function; vascular dysfunction.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Aged
  • Animals
  • Anthracyclines / adverse effects
  • Arteries
  • Cardiovascular Diseases* / chemically induced
  • Child
  • Female
  • Humans
  • Male
  • Mice
  • Neoplasms* / drug therapy
  • Polyketides* / therapeutic use
  • Translational Research, Biomedical
  • Young Adult

Substances

  • Anthracyclines
  • Polyketides