Molecular Mechanisms of Cardiotoxicity: A Review on the Major Side-effects of Doxorubicin

Doxorubicin is a secondary metabolite produced by Streptomyces peucetius var. caesius and belongs to anthracyclines (ANTs) family. It is an efficient antineoplastic agent used for the treatment of child and adult cancers such as solid tumours, leukaemia, lymphoma and breast cancer. Optimal administration of doxorubicin is hampered due to some toxicity such as hematopoietic suppression, nausea, vomiting, extravasation, alopecia, and cardiotoxicity[1]. Cytotoxic chemotherapy-induced cardiotoxicity has a high incidence[2]. Cardiotoxicity included shortand longterm toxic effects in the heart ranging from alterations in myocardial structure and function to severe cardiomyopathy and heart failure that may result in cardiac transplantation or death. Chronic cardiotoxicity occurred after prolonged administration of doxorubicin. Although the possibility of cardiotoxicity development is dose dependent, but it could occur even at lower dose due to individual variations[3].