• Daniela Cardinale, Federica Stivala, and Carlo M Cipolla.
• a Cardioncology Unit, Cardiology Division , European Institute of Oncology , I.R.C.C.S., Milan , Italy.
• Expert Rev Anticancer Ther. 2019 May 1; 19 (5): 359-374.

IntroductionRecent breakthroughs in cancer treatment has improved the prospects and life expectancy of cancer patients. Therefore, risk of cardiotoxicity induced by oncologic therapies has become an important determinant of patient's survival and quality of life, independently of the oncologic prognosis. Areas covered: This paper provides an overview of the proposed strategies to mitigate the risk of cardiotoxicity. Limitation of current approaches, the need for early detection and the treatment of cardiotoxicity are also discussed. Possible future research directions are also described. Expert opinion: The most effective approach to minimize cardiotoxicity is early identification and early onset of a prophylactic treatment. However, the current standard of cardiac monitor identifies cardiotoxicity only when a functional impairment has already occurred, precluding any chance of effective prevention. The use of troponins to identify subclinical cardiotoxicity, and early treatment with ACE-inhibitors to prevent cardiac dysfunction and cardiac events have recently emerged, and appear to be an effective tool against this complication.

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