Chemotherapy-induced cardiotoxicity: a new perspective on the role of Digoxin, ATG7 activators, Resveratrol, and herbal drugs

Abstract

Cancer is a major public health problem, and chemotherapy plays a significant role in the management of neoplastic diseases. However, chemotherapy-induced cardiotoxicity is a serious side effect secondary to cardiac damage caused by antineoplastic's direct and indirect toxicity. Currently, there are no reliable and approved methods for preventing or treating chemotherapy-induced cardiotoxicity. Understanding the mechanisms of chemotherapy-induced cardiotoxicity may be vital to improving survival. The independent risk factors for developing cardiotoxicity must be considered to prevent myocardial damage without decreasing the therapeutic efficacy of cancer treatment. This systematic review aimed to identify and analyze the evidence on chemotherapy-induced cardiotoxicity, associated risk factors, and methods to decrease or prevent it. We conducted a comprehensive search on PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) using the following keywords: "doxorubicin cardiotoxicity", "anthracycline cardiotoxicity", "chemotherapy", "digoxin decrease cardiotoxicity", "ATG7 activators", retrieving 59 articles fulfilling the inclusion criteria. Therapeutic schemes can be changed by choosing prolonged infusion application over boluses. In addition, some agents like Dexrazoxane can reduce chemotherapy-induced cardiotoxicity in high-risk groups. Recent research found that Digoxin, ATG7 activators, Resveratrol, and other medical substances or herbal compounds have a comparable effect on Dexrazoxane in anthracycline-induced cardiotoxicity.

Cytotoxic Effect of YH239-EE and Its Enantiomer on MCF7 Cell Line

“…Several research studies have been conducted to make anticancer treatments more selective in treating cancer without side effects [34]. However, the MDM2 inhibitor drugs have a promising vision in this regard; in our research, the MTT assay shows that both YH239 and YH239-EE have cytotoxic effects with different IC 50 values (the IC 50 value of YH239 was about 37.78 and YH239-EE was about 8.45 µM).…”

Guideline-directed medical therapy in chemotherapy-induced cardiotoxicity and heart failure: current perspectives and practices

“…Digoxin is an effective treatment for CIC, including anthracycline-induced cardiotoxicity, and may have an anti-cancer effect. However, the combination of digoxin and doxorubicin increases the level of histone H2AX, which is associated with DNA changes and induction of apoptosis [60] . Dexrazoxane reduces cardiotoxicity by chelating free radical iron, but resveratrol significantly reduces free radicals and doxorubicin cardiotoxicity compared with dexrazoxane [61] .…”

Deciphering the Protective Effects of Carvacrol Against Doxorubicin-Induced Cardiotoxicity In Vitro and In Vivo

“…Chemotherapy and radiotherapy stand as indispensable cornerstones in the comprehensive treatment of diverse cancer types, playing a pivotal role in substantially enhancing survival rates across a burgeoning patient population 5 . However, despite its importance, chemotherapy faces signi cant hurdles in patient care.…”