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Anthracycline Cardiotoxicity: From Bench to Bedside

Luca Gianni, Eugene H. Herman, Steven E. Lipshultz, Giorgio Minotti, Narine Sarvazyan, Douglas B. Sawyer

From the Division of Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Instituto Nazionale Tumori, Milan; Center for Integrated Research and Drug Sciences, University Campus Bio-Medico of Rome, Rome, Italy; Division of Applied Pharmacology Research, Food and Drug Administration, Silver Spring, MD; Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami; Holtz Children's Hospital of the University of Miami/Jackson Memorial Medical Center; The University of Miami Sylvester Comprehensive Cancer Center, Miami, FL; Department of Pharmacology and Physiology, George Washington University School of Medicine, Washington, DC; and Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN

Corresponding author: Steven E. Lipshultz, MD, Department of Pediatrics (D820), Leonard M. Miller School of Medicine, University of Miami, PO Box 016820, Miami, FL 33101; e-mail: slipshultz{at}med.miami.edu

Anthracyclines remain among the most widely prescribed and effective anticancer agents. Unfortunately, life-threatening cardiotoxicity continues to compromise their usefulness. Despite more than four decades of investigation, the pathogenic mechanisms responsible for anthracycline cardiotoxicity have not been completely elucidated. In addition, new drugs and combination therapies often exacerbate the toxicity. The First International Workshop on Anthracycline Cardiotoxicity, held in fall 2006, in Como, Italy, focused on the state-of-the-art knowledge and discussed the research needed to address the cardiotoxicity of these drugs. Here, we incorporate these discussions into the framework of a broader review of preclinical and clinical issues.

G.M. and the Menarini Foundation organized the International Workshop on Anthracycline Cardiotoxicity that inspired this article. G.M. and N.S. co-chaired the Scientific Program. S.E.L., G.M., E.H.H., and N.S. coordinated the Discussion Panels. G.M. is supported by Associazione Italiana Ricerca sul Cancro.

All authors contributed equally to this article.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.