Advancements in Anthracycline-Induced Cardiotoxicity Research: A Cross-Sectional Analysis of Interventional Clinical Trials from the International Clinical Trial Registration Platform

Abstract

Background: Anthracyclines are highly effective chemotherapeutic agents widely used in the treatment of various malignancies. However, their use is often limited by the occurrence of cardiotoxicity, which can lead to serious cardiovascular complications and a decreased quality of life for cancer survivors. This study aimed to provide a comprehensive overview of interventional clinical trials focusing on anthracycline-induced cardiotoxicity (AIC) by analyzing data from the International Clinical Trial Registration Platform (ICTRP).

Methods: The International Clinical Trial Registration Platform served as the data source, with information collected from each trial. Linked publications were searched through PubMed and Google Scholar.

Results: A total of 100 interventional trials were identified, predominantly conducted in North America, Europe and Asia. Most trials were prospective and focused on prevention and treatment. The trials' interventions were categorized into five main classes: cardioprotective agents, monitoring strategies, exercise and lifestyle interventions, and novel strategies like device and stem cell therapy. Cardioprotective agents, particularly neurohormonal antagonists, and monitoring strategies for early detection were extensively studied. Exercise and lifestyle interventions, although were underrepresented, showed promising effects on anthracycline-induced cardiotoxicity management. Specifically, structured exercise programs were highlighted as effective in improving cardiovascular health in cancer survivors. Novel strategies such as stem cell therapy and devices were in their early stages. By 2023, 32 publications were produced from 27 clinical trials. These publications indicated heterogeneity in the efficacy of cardioprotective agents, while exercise interventions demonstrated significant potential in reducing anthracycline-induced cardiotoxicity.

Conclusion: Interventional clinical trials targeting anthracycline-induced cardiotoxicity offered hopes for improving the safety and efficacy of anthracycline-based chemotherapy. Despite challenges, the diverse range of strategies and promising findings underscored the importance of continued research. Specifically, the positive impact of exercise interventions warrants further investigation and integration into clinical practice to optimize outcomes for patients.

Keywords: anthracycline-induced cardiotoxicity, interventional clinical trials, International Clinical Trial Registration Platform, Cardiovascular health