Table 1.

Representative drugs to reduce cardiac toxicity caused by tumor treatment in published works.

Category	Compound/Herb Name	Source	Chemotherapy Drug	Experimental Model	Mechanism of Action	Ref.
Phenol acid	Salvianolic acid	Salvia miltiorrhiza	DOX	Male KM mice	Increased absorbance of oxygen radicals, decreased levels of creatine kinase and malondialdehyde.	[255]
	Curcumin	Turmeric	DOX	Kunming mice, primary neonatal rat cardiomyocytes	Regulated the 14-3-3γ/BAD/Bcl-2 pathway and mPTP.	[37]
	Resveratrol	Grapes and peanuts	DOX	Male Sprague-Dawley rats, rat embryonic cardiomyoblast-derived cells, H9c2 cells, male FBN rats	Regulated VEGF-B/Akt/GSK-3β signaling pathway; regulated mTOR, AMPK, and SIRT1 pathways.	[258]
Polysaccharides	Ganoderma lucidum polysaccharides	Ganoderma lucidum	DOX	H9c2, MCF-7, HepG2 cells	Regulated polyubiquitin modification, inhibited the NF-κB signaling pathway.	[262]
	Astragalus polysaccharide	Astragalus membranaceus	DOX	Neonatal rat ventricular myocytes, male C57BL/6 mice	Activated the PI3K/Akt pathway, inhibited the p38MAPK pathway, reduced levels of caspase 3 and caspase 9.	[263]
	Ganoderma atrum polysaccharide (PSG-1)	Ganoderma atrum	DOX	Kunming mice, primary myocardial cells	Improved antioxidant capacity, reduced cytochrome-c release, increased mitochondrial membrane potential, inhibited mPTP opening.	[264]
Flavonoids	Chrysin	Mushrooms, bee propolis, et al.	DOX	Male Sprague-Dawley rats	Regulated oxidative stress, as well as VEGF/PI3K/Akt, p53, p38, JNK, and NF-κB signaling pathways.	[271]
	Cardamonin	Alpinia katsumadai, Ginkgo biloba, and Carya cathayensis Sarg	DOX	Male C57BL/6 J mice, rat-myocardium-derived cardiomyoblast H9C2 and mouse cardiomyocyte HL-1	Regulated Nrf2, NF-κB, and caspase-3 pathways.	[272]
	Calycosin	Radix astragali	DOX	Rat cardiomyocyte line H9c2, male Kunming mice	Inhibited Bax; increased Bcl-2; activated PI3K/Akt pathway; reduced NLRP3, TXNIP, IL-1β, and caspase-1.	[273]
Saponin	Ginsenoside Rg3	Ginseng	DOX	Adult male Sprague-Dawley rats, cardiac microvascular endothelial cells from neonatal rats	Increased EF and FS, improved LV outflow, activated Nrf2-ARE and Akt pathways.	[280]
	Astragaloside IV	Astragalus membranaceus	DOX	C57BL/6 mice, NRCMs	Alleviated myocardial fibrosis and left-ventricular systolic dysfunction, inhibited NOX2 and NOX4.	[281]
	Saikosaponin D	Radix bupleuri	DOX	Male mice	Inhibited excessive oxidative stress via the p38MAPK signaling pathway.	[282]
Alkaloids	Neferine	Nelumbo nucifera Gaertn	DOX	Rat cardiomyoblasts, H9c2	Activated IGF-1R, PI3K/Akt/mTOR pathway, increased expression of SOD-1 and HO-1.	[294]
	Berberine	Rhizoma coptidis	DOX	Sprague-Dawley rats, rat cardiac H9c2 cell line	Improved ST, QRS complexes, and QT; regulated SIRT1-p66shc pathway.	[295]
	Cyclovirobuxine D	Buxus microphylla	DOX	C57BL mice injected (i.p.) with DOX	Ameliorated cardiac oxidative damage, prevented impairment of mitochondrial biogenesis.	[304]
Single herb	-	Platycodon grandiflorum	DOX	Clinical trial	Ongoing	[299]
	-	Hypericum hircinum	DOX	Wistar rats	Increased antioxidant defenses, reversed ECG changes, and prevented reductions in heart weight.	[300]
	-	Lycium barbarum	DOX	Male Sprague-Dawley rats	Prevented loss of myofibrils and improved heart function, normalized antioxidative activity.	[301]
TCM formulation	Modified ZGCT	Radix Glycyrrhirae preparata, Radix Ginseng, Ramulus Cinnamomi, Colla Corii Asini, Radix Rehmanniae, Radix Ophiopogonis, et al.	DOX	18-year-old male adolescent with refractory acute lymphoblastic leukemia	Chest radiograph showed great improvements in pulmonary edema and cardiomegaly.	[302]
	Antarth	Boswellia serrata, Commiphora mukul, Withania somnifera, Smilax china, Tribulus terrestris, Curcuma longa, et al.	DOX	12-week-old male Swiss albino mice	Inhibited DOX-induced decline in antioxidant status.	[303]
	Tongmai Yangxin pills	Radix Rehmanniae, Radix Glycyrrhizae, Ramulus Cinnamomi, Fructus Schisandrae, Radix Ophiopogonis, Radix Polygoni multiflori preparata, et al.	Cisplatin	Male Wistar rats	Improved anti-oxidative stress and reduced apoptosis through regulating Nrf2/HO-1 and p38MAPK pathways.	[298]