Mechanistic science in cardiovascular-oncology: the way forward to maximise anti-cancer drug effects and minimise cardiovascular toxicity

Abstract

Dramatic improvements in cancer survival have arisen because of the rapid development of novel anti-cancer therapies. The potential for cardiovascular toxicity associated with these drugs often reflects overlap between pathogenic cancer mechanisms and physiological pathways required for normal cardiovascular function. Clinical Science has, therefore, compiled a themed collection on Cardiovascular-Oncology. This collection examines the intersection between cancer treatments and their potentially harmful cardiovascular effects. By defining the mechanisms underlying unwanted cardiovascular effects of anti-cancer therapies, cardioprotective strategies can be developed. Only by doing so, will patients be able to achieve optimal cancer treatment at the minimum cost to cardiovascular health.

The importance of microvascular inflammation in ageing and age-related diseases: a position paper from the ESH working group on small arteries, section of microvascular inflammation

“…Particularly relevant is that several cancer treatments present CV toxicity and may cause MD, microvascular inflammation, hypertension and thus, an increase in CV events [321,322]. While anthracyclines have been mostly related to specific cardiotoxicity [323], VEGF and other tyrosine kinase inhibitors are the most frequently associated anticancer drugs with a dose-dependent increase in blood pressure both in hypertensive patients and in normotensive subjects [322,324,325]. These drugs enormously improve the prognosis for several solid tumours [326], targeting specific pro-angiogenic VEGF signalling involved in the neovascularization of tumours in vivo [327].…”

“…The better identification of the mechanisms underlying adverse cardiac and vascular effects of anticancer therapies may allow to develop novel vasculoprotective strategies. Only by doing so will patients achieve optimal cancer treatment at the minimum cost to cardiac and vascular health [323].…”

Oxidative Stress and Pyroptosis in Doxorubicin-Induced Heart Failure and Atrial Fibrillation

“…However, the incidence and mortality due to complications induced by anticancer treatments have increased each year. Cardiovascular disease is the most common adverse reaction of antitumor therapy [1,2]. Doxorubicin (Dox) is an antitumor drug that is widely used against a variety of malignant tumors, including lymphoma, leukemia, and breast cancer.…”

“…However, the incidence and mortality due to complications induced by anticancer treatments have increased each year. Cardiovascular disease is the most common adverse reaction of antitumor therapy [ 1 , 2 ].…”