Doxorubicin Cardiotoxicity: Preclinical and Clinical Circulating Protein Markers

Cardiotoxicity remains one of the major threats to cancer patients treated with the potent anticancer drug doxorubicin. It has become a significant challenge in the posttreatment management of the growing population of cancer survivors. Among several risk factors, the lifetime cumulative dose of doxorubicin is considered a key determinant in the development of cardiotoxicity that can manifest into life-threatening congestive heart failure years after completion of treatment. A lack of reliable clinical measures with high sensitivity and specificity to identify early signs of heart failure in cancer patients has led to enormous efforts in cardio-oncology to discover early circulating biomarkers of doxorubicin cardiotoxicity. This chapter discusses promising preclinical and clinical circulating protein markers associated with oxidative stress, endothelial cellular injury, inflammation, immune response, hypertrophy, and fibrosis in the heart that may have the potential to predict the risk of cardiotoxicity in cancer patients treated with doxorubicin-based chemotherapy.