Doxorubicin Induced Cardiotoxicity: Possible Cause and Preventions

Doxorubicin/Adriamycin (Dox) is a powerful, well established and highly efficacious drug in the fight against many kinds of cancers like solid tumors, leukemia’s, soft tissue sarcoma, breast cancer, small cell carcinoma of the lung and esophageal carcinomas. But its clinical usefulness is still restricted due to its specific toxicities to cardiac tissues. Congestive heart failure, cardiomyopathy, and electrocardiographic changes were demonstrated after cumulative Dox administration. The possible mechanisms proposed for cardiotoxic effects of Doxorubicin include free radical induced myocardial injury, lipid peroxidation, mitochondria damage, decreased activity of Na, K-adenosine triphosphate, vasoactive amine release, impairment in myocardial adrenergic signaling/regulation and cellular toxicity. Increased oxidative stress and release free radicals, including super oxide anion (O2 ) and other reactive oxygen intermediates as well as endogenous antioxidant deficits have been suggested to play a major role in Doxinduced cardiomyopathy and heart failure. In the same context the possible cause of Dox inducing cardiotoxitiy will be discussed along with the various till date possibilities for its prevention.