Cardiotoxicity due to biological cancer therapy

Cardiotoxicity has been increasingly reported as a side effect of oncologic treatment, including novel targeted biological therapy. Specific monoclonal antibodies or tyrosine kinase inhibitors have been developed for blockade of HER2 receptors, VEGF receptors, or Abl kinase activity. However, these actions also interfere with molecular mechanisms that are crucial for cardiovascular health. Anti HER2 therapy generally induces reversible systolic left ventricular dysfunction, whereas VEGF receptor blockade leads to development of arterial hypertension and increased susceptibility to thromboembolic events. In patients developing cardiotoxicity, better clinical outcome and quality of life can be achieved by early recognition and treatment, thus also enabling continuation of anti-cancer therapy in many cases. A multidisciplinary approach including cardiologists and oncologists, along with regular cardiologic follow up, is crucial for successful patient management.