Mitigating Cardiotoxicity Associated with Anticancer Drugs: An Updated Systematic Review

Abstract

Introduction: This systematic review investigated strategies to mitigate cardiotoxicity induced by anticancer medications, emphasizing exercise and pharmacological interventions. Methods: We systematically reviewed three randomized controlled trials (RCTs), one ATOPE trial, and one retrospective cohort study. Results: Among 448 patients, exercise interventions, particularly in breast cancer patients, demonstrated significant improvements in left ventricular ejection fraction (LVEF) and cardiotoxicity prevention. Pharmacological interventions, including candesartan and carvedilol, have shown potential in reducing early DOX-induced subclinical cardiotoxicity (DISC). The protective efficacy of candesartan in alleviating DISC was greater than carvedilol and the control group. Combination therapy with lisinopril and bisoprolol effectively preserved the LVEF. A retrospective cohort study demonstrated the cardioprotective potential of SGLT-2 inhibitors in reducing cardiovascular events. Conclusion: This systematic review underscores the promise of exercise and pharmacological interventions for preserving cardiac function in cancer patients receiving chemotherapy. These findings have significant implications for enhancing the quality of care for cancer patients.

Keywords

• Anticancer drugs
• cardiotoxicity
• doxorubicin
• left ventricular ejection fraction