Taking cancer-drug toxicity to heart.

It’s a big problem driven by a big success. Doxorubicin (Adriamycin; Pfi zer) and other anthracyclines effectively treat leukemias, lymphomas, and several types of solid tumors, including breast cancer. The success of these chemotherapies is one driver of the dramatic improvements in survival rates for childhood cancers since the 1970s. Sadly, the drugs have been linked to subsequent heart failure in cancer survivors. A 2009 study noted that more than 7.5% of children treated with anthracyclines will develop heart failure within 30 years. Adults aren’t immune to the problem: For example, 1% to 2% of breast cancer patients treated with anthracyclines develop drug-related heart failure; others may have asymptomatic cardiomyopathy, pushing the true incidence of heart failure even higher. Although some risk factors have been identifi ed, no one knows exactly which patients will develop a problem, says Maryam Lustberg, MD, a medical oncologist specializing in breast cancer at Ohio State University in Columbus, OH. “It’s really anyone’s guess,” she says.