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Mechanisms and Genetic Susceptibility of Chemotherapy-Induced Cardiotoxicity in Patients With Breast Cancer

Mihalcea, Diana J. MD; Florescu, Maria MD, PhD; Vinereanu, Dragos MD, PhD, FESC, FRCP

doi: 10.1097/MJT.0000000000000453
Systematic Review and Clinical Guidelines

Background: Cardiotoxicity remains an important adverse reaction of chemotherapy used in the treatment of breast cancer, leading to increased morbidity and mortality.

Data Sources: Anthracyclines, taxanes, and trastuzumab are the most commonly used cytotoxic drugs for the treatment of breast cancer. Cardiotoxicity may vary from asymptomatic forms to irreducible heart failure and death.

Areas of Uncertainty: Susceptibility for the occurrence of chemotherapy-induced cardiotoxicity and treatment resistance is multifactorial, with interindividual variability, determined by the interaction between genetic and phenotypic factors. Implementation of pharmacogenomic findings into clinical practice might be useful, to predict cardiotoxicity and to allow appropriate therapeutic measures.

Results and Conclusions: This review will summarize the cellular mechanisms of chemotherapy-induced cardiotoxicity in breast cancer patients and will discuss the role of the genetic susceptibility for cardiac dysfunction.

1University and Emergency Hospital, Bucharest, Romania; and

2Department of Cardiology, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.

Address for correspondence: University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Splaiul Independentei 169, Bucharest 050098, Romania. E-mail:

Supported by a grant of the Romanian National Authority for Scientific Research, CNCSIS–UEFISCDI, project number PN-II-ID-PCE-2011-3-0791, 112/27.0ct.2011., NCT4192910, and partly supported by the Sectorial Operational Program Human Resources Development, financed by the European Social Fund and the Romanian Government under the contract number POSDRU 141531.

The authors have no conflicts of interest to declare.

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