Table 1.
Characteristics of type I and II chemotherapy-induced cardiotoxicity.
| Type I (Myocardial Damage) | Type II (Myocardial Dysfunction) | |
|---|---|---|
| Representative agents | Anthracyclines (DOX) | Trastuzumab |
| Bevacizumab | ||
| Sunitinib | ||
| Sorafenib | ||
| Dose-dependence | Yes | No |
| Mechanism | Free radical formation | Inhibition of Erb signaling |
| DNA damage | ||
| Oxidative damage | ||
| Clinical manifestation | Underlying damage appears to be permanent and irreversible | High likelihood of recovery (to or near baseline cardiac status) in 2–4 months (reversible) |
| Biopsy presentation | Myofibril disarray | Minimal changes have been reported |
| Vacuole formation | ||
| Effect of rechallenge | High probability of recurrent dysfunction that is progressive, leading to intractable heart failure and death | Increasing evidence for the relative safety of rechallenge; additional data needed |