Klin Onkol 1997; 10(3): 71-76.
The anthracyclines are a very important group of antitumour agents. Clinical use of anthracyclines is often limited by the development of cardiac toxicity. Cardiotoxicity can present in three forms: an acute, usually reversible effect on heart function, subacute and chronic, irreversible cardiac damage. Chronic cardiotoxicity eventually leads to cardiomyopathy and congestive heart failure. The factors that increase an individual´s risk of developing anthracycline-induced cardiomyopathy are either therapy-related or patient-related. The simplest precaution for preventing cardiotoxicity is to stop treatment when the dose has reached the recommended cumulative dose. However, it is more accurate to monitor cardiac damage by means of echocardiography, radionuclide angiography, exercise stress tests, immunoscintigraphy or cardiac biopsy. There are currently three ways in which anthracycline-induced cardiotoxicity may be prevented: alteration of the drug administration schedule, the use of new, non-toxic anthracyclines and the use of cardioprotective drugs. Cardioprotective agents are drugs given before the chemotherapeutic drug with the aim of preventing cardiotoxicity. The most promising of these seems to be ICRF-187 (Cardioxane), which acts by preventing the iron-dependent generation of oxygen free radicals.
