Role of biomarkers in chemotherapy-induced cardiotoxicity.

Chemotherapy-induced cardiotoxicity remains an unresolved problem strongly impacting the quality of life and the overall survival of cancer patients. The main strategy for minimizing cardiotoxicity is early detection of high-risk patients and prompt prophylactic treatment. The current standard for monitoring cardiac function detects cardiotoxicity only when a functional impairment has already occurred, not allowing for any early preventive strategies. Measurement of cardiospecific biomarkers can be a valid diagnostic tool for early identification, assessment, and monitoring of cardiotoxicity. In particular, the role of troponin in identifying patients at risk of cardiotoxicity and of angiotensin-converting enzyme inhibitors in preventing cardiac dysfunction and cardiac events is clearly emerging as a new effective approach. Therefore, we propose troponin as a criterion standard marker for the assessment of cardiac risk of both old and new antineoplastic treatments, and its evaluation should be included among the criteria utilized to define cardiotoxicity. Copyright 2010 Elsevier Inc. All rights reserved.