Cardiovascular toxicity in antitumor therapy: biological and therapeutic insights

HighlightsThis review emphasizes the need for a deep understanding of diverse biological mechanisms driving cardiovascular toxicities across various antitumor therapies, including immunotherapy, chemotherapy, radiotherapy, and targeted therapy.It outlines future research directions, emphasizing the exploration of biological mechanisms underlying cardiotoxicity and the development of cardioprotective agents to improve patient care in oncology.Emerging therapeutic strategies like the use of polyphenols, nanoparticles, and advanced drug delivery systems are discussed as innovative approaches to mitigate cardiovascular toxicities.AbstractThe evolution of antitumor therapies has significantly improved cancer prognosis but has concurrently resulted in cardiovascular toxicities. Understanding the biological mechanisms behind these toxicities is crucial for effective management. Immunotherapy-related cardiovascular toxicities are primarily mediated by immune cells and secreted cytokines. Chemotherapy may cause cardiovascular damage through autophagy disruption and mitochondrial dysfunction. Targeted therapies can induce toxicity through endothelin-1 (ET-1) production and cardiac signaling disruption. Radiotherapy may lead to cardiomyopathy and myocardial fibrosis by affecting endothelial cells, triggering inflammatory responses and accelerating atherosclerosis. This review provides insights into these mechanisms and strategies, aiming to enhance the clinical prevention and treatment of cardiovascular toxicities.