Table 1.
Cardiotoxicities Associated With Common Cancer Therapeutics
| Chemotherapy | Cardiotoxicity (relative incidence*) |
| Anthracyclines | |
| Doxorubicin/Daunorubicin | Heart failure/left ventricular dysfunction (common), arrhythmias |
| Epirubicin | Heart failure/left ventricular dysfunction (common) |
| Antimetabolites | |
| 5‐Fluorouracil | Cardiac ischemia (intermediate), arrhythmias, angina, heart failure |
| Methotrexate | Pericardial effusion |
| Capecitabine | Cardiac ischemia (intermediate) |
| Platinum‐based | |
| Cisplatin | Arrhythmias (rare), angina (rare) |
| Microtubule inhibitors | |
| Paclitaxel | Heart failure/left ventricular dysfunction (intermediate), cardiac ischemia (rare), QTc prolongation (rare), arrhythmia (rare) |
| Docetaxel | Heart failure/left ventricular dysfunction (intermediate), cardiac ischemia (rare) |
| Alkylating agents | |
| Cyclophosphamide | Heart failure/left ventricular dysfunction (intermediate), angina |
| Ifosfamide | Heart failure/left ventricular dysfunction (rare), arrhythmias |
| Mitomycin | Heart failure (common) |
| Immunotherapy | |
| Monoclonal antibodies | |
| Trastuzumab (HER‐2) | Heart failure (intermediate‐common), hypertension (intermediate) |
| Bevacizumab (vascular endothelial growth factor) | Hypertension (common), myocardial ischemia (intermediate‐common), heart failure (intermediate) |
| Rituximab (CD‐20) | Arrhythmia, heart failure, myocardial ischemia |
| Immune checkpoint inhibitors | |
| Pembrolizumab/Nivolumab (PD‐1) | Myocarditis/pericarditis (intermediate, more common with combined immune checkpoint inhibitor therapy), heart failure (rare), arrhythmias (rare), pericardial disease (rare), atherosclerotic disease |
| Ipilimumab (CTLA‐4) | |
| Chimeric antigen T‐cell therapies | |
| Tisagenlecleucel | Arrhythmia† (common), ventricular dysfunction† (common) |
| Axicabtagene ciloleucel | |
| Tyrosine kinase inhibitors | |
| Imatinib | Heart failure (rare), arrhythmias (rare) |
| Dasatinib | Heart failure (common), pulmonary hypertension (rare) |
| Nilotinib | Heart failure, myocardial ischemia (common), QT prolongation (intermediate) |
| Sunitinib | Hypertension (common), heart failure (intermediate‐common) |
| Sorafenib | Hypertension (common), heart failure (intermediate‐common) |
| Ponatinib | Myocardial ischemia (common), hypertension (common), heart failure (intermediate‐common), arrhythmias (intermediate), peripheral vascular disease |
| Proteasome inhibitors | |
| Bortezomib | Heart failure (intermediate‐common), arrhythmia, myocardial ischemia |
| Thoracic radiation‡ | Myocardial ischemia (common), conduction abnormalities (common), peripheral vascular disease (common), heart failure (common), valvular disease (intermediate‐common), pericardial disease (intermediate) |
*When possible, the incidence of each reported cardiotoxicity is categorized as rare <1%, intermediate 1% to 5%, or common >5%. However, the incidence of many toxicities cannot be determined reliably owing to insufficient data.
†Occur in setting of cytokine release syndrome.
‡The overall incidence of radiation‐induced cardiotoxicity varies depending on dose and historical era. Incidence of fatal radiation‐associated cardiotoxicity is estimated at 1% to 7%.