Anthracycline-induced cardiotoxicity: emerging mechanisms and therapies

Chemotherapy-induced cardiovascular disease has become one of the main causes of death in cancer survivors. Several international authoritative societies have developed a number of guidelines to standardize clinical practice for the emerging discipline of cardio-oncology, aiming to allow patients to receive cancer treatment while reducing the risk of cardiovascular events. Anthracyclines, as the earliest first-line chemotherapy drugs, have attracted much attention from researchers due to their severe cardiotoxicity. Although targeted therapy and immunotherapy strategies improve anticancer efficacy, they also increase the risk of cardiotoxicity. Therefore, anthracyclines are still indispensable in cancer treatment, and in-depth understanding of the mechanism of cardiotoxicity will help to develop effective therapeutic strategies. This review aims to summarize the new mechanisms of cardiotoxicity caused by anthracyclines and current emerging therapeutic strategies.