Managing cardiotoxicity in anthracycline-treated breast cancers

Anthracyclines are among the most active chemotherapeutic agents in cancer treatment. Although infrequent, cumulative dose-dependent cardiotoxicity is nevertheless a significant side effect of this therapy resulting in reduced cardiac reserve or even frank cardiac failure. Although used in several types of malignancy, anthracyclines are most commonly used in breast cancer treatment. Importantly, recent advances have also seen the increasing use of another cardiotoxic agent, the monoclonal antibody trastuzumab, both in the metastatic as well as in the adjuvant breast cancer setting. This review discusses the relationship of cardiotoxicity and anthracycline use, particularly in the breast cancer setting, and explores available treatment options for the anthracycline-treated patients based on evidence from recent Phase III trials.