Cardiac Dysfunction Due to Cancer Therapy

C ardiac toxicity of cancer therapies remains an important clinical problem, despite decades of investigation. The prevention, surveillance, and treatment of cardiac toxicity are areas of active research, stimulated by recent attention from the National Institutes of Health. 1 This has brought new energy and novel methods to the table. For patients facing treatment of cancer, no one size fits all, and several teams of investigators have tried to identify genetic variables or biomarkers that might predict the risk for cardiac injury by anthracyclines and allow for a more personalized approach that allows for a cancer patient to receive the maximal benefit of these powerful chemotherapies at minimal risk. These studies have identified many molecular pathways that may be important determinants of cardiotoxicity and have led to recent proposals for use of genetic testing in this setting.