Role of biomarkers in monitoring antiblastic cardiotoxicity

(CTX) has been evaluated by most internationalscientific cardiology and oncology societies. Highexpectations have been placed on the use of specificbiomarkers. In recent years, conventional biomarkersand molecules of more recent interest have beentested and compared in the context of anticancerdrug-related CTX. Encouraging results wereobtained from studies on molecules of myocardialdamage, such as troponin and markers of myocardialwall stress, including circulating natriuretic peptides,as well as from the assessment of the products ofinflammation or circulating levels of free radicals.However, clear guidelines on their sensitivity,specificity, and accuracy are not yet available, andmany challenges, such as the optimal time of assessing,optimal schedule for evaluation, optimal cut-off pointfor positivity with the highest level of specificity,and optimal comparability of different assays forthe measurements, remain unresolved. Given theimportance of having a reliable and accuratetool for monitoring anticancer drug-induced CTX,this review will focus on the available data on the mosteffective and widely used biomarkers and the studies thatare currently underway that aim to identify theeffectiveness of new approaches in this therapeuticsetting.