Anthracycline Side Effects Double Heart Failure Risks in Some Cancer Patients: Study

Heart failure risks from anthracycline were linked to high doses, as well as long-term and short-term side effects

New research raises concerns about the potential side effects of anthracycline drugs, which are a class of chemotherapy drugs, indicating they may cause cancer patients to face a significantly increased the risk of developing heart failure.

In findings published this month in the medical journal JAMA Network Open, researchers from the Mayo Clinic indicate anthracycline drugs doubled the incidence heart failure, compared to patients who did not take the drugs, and the risk remained elevated for decades.

Researchers conducted a case-controlled study involving nearly 2,200 participants, including residents of Olmsted County, Minnesota. The study included patients who were diagnosed with breast cancer or lymphoma from 1985 to 2010, and matched with control patients who did not have cancer.

The study used data from the Rochester Epidemiology Project, which resulted in 800 participants with cancer and nearly 1,400 control participants.

Anthracycline Heart Failure Risks

The incidence of heart failure among individuals with cancer who were treated with anthracyclines was 7%, across 15 years. This rate was two times higher than the rate of heart failure in patients who didn’t take anthracyclines.

Anthracyclines are a class of chemotherapy drugs, which includes medications like Rubex, Cerubidine, Ellen, and Idamycin, which are used to treat a range of cancers, including leukemia, lymphoma, breast, ovarian, and lung cancers. This class of drug is among the most effective anticancer drugs, but is known to be cardiotoxic and can lead to side effects like heart dysfunction, myocarditis, atrial fibrillation, and tachycardia.

There was no significant risk of heart failure among patients who received anthracyclines at a dose of less than 180 mg/m² compared with patients who took doses of 180 mg/m² to 250 mg/m² or doses of more than 250 mg/m^2.

Conversely, patients who underwent radiation therapy instead of chemotherapy did not experience heart failure and seemed to have a protective relationship against heart failure from the radiation treatment.

The findings of the new study indicate the chemotherapy drugs can have significant toxic effects on the heart. A small group of cancer patients in the same study who were not treated with anthracycline drugs saw no increased risk of heart failure.

The patient group which underwent chemotherapy with anthracyclines faced an increased risk in the first year and the risk continued for decades, indicating the risk to patients was both short-term and long-term.

“These findings suggest that anthracycline treatment in patients with cancer was associated with more than twice the risk of heart failure compared with controls,” researchers concluded.

The findings highlight the need for improved surveillance and treatment strategies for cancer patients who are treated with chemotherapy, they determined. It is also important to study how anthracyclines work to provide better recommendations for treatment and risk, the researchers reported.