Cardiovascular Effects in Childhood Cancer Survivors Treated with Anthracyclines

Table 2

Areas for future research in anthracycline cardiotoxicity.^a

Basic research	Clinical research
(1) Exploration beyond the oxidative stress hypothesis as a primary mechanism of anthracycline cardiotoxicity	(1) Reduction of anthracycline cardiotoxicity in clinical practice
(2) Implementation of long-term studies in animal models	(2) Identification of early signs of cardiac damage
(3) Identification of predictive markers of cardiac damage	(3) Educate clinicians: anthracycline-induced cardiotoxicity can initially respond to cardiac medications
(4) Determination of the relative impact of different mechanisms of myocardial damage	(4) Determination of the cardiotoxicity of targeted and combination therapies
(5) Exploration into the relationship between growth factors and anthracyclines	(5) Identification of a balance between cardiotoxicity with clinical benefit
(6) Understanding drug interactions in new combination therapies	(6) Definition of risks and benefits for subgroups of patients
(7) Assessment of the effects of anthracyclines on cardiac development	(7) Management of cardiac dysfunction in cancer survivors treated with anthracyclines
(8) Assessment of the effects of anthracyclines on non-myocyte cardiac cells	(8) Specifications of dietary and exercise recommendations for anthracycline-treated patients
(9) Assessment of risk-benefit factors in groups with compounding risk factors for cardiomyopathy	(9) Understanding the progression of anthracycline cardiomyopathy: systolic versus diastolic heart dysfunction
(10) Determination of genetic predispositions to anthracycline cardiotoxicity	(10) Expansion of the use of dexrazoxane and liposomal anthracyclines

^aData from Gianni et al. [23].