TY - JOUR T1 - Insights into Doxorubicin-induced Cardiotoxicity: Molecular Mechanisms, Preventive Strategies, and Early Monitoring JF - Molecular Pharmacology JO - Mol Pharmacol SP - 219 LP - 232 DO - 10.1124/mol.119.115725 VL - 96 IS - 2 AU - Nadine Wenningmann AU - Merle Knapp AU - Anusha Ande AU - Tanaya R. Vaidya AU - Sihem Ait-Oudhia Y1 - 2019/08/01 UR - http://molpharm.aspetjournals.org/content/96/2/219.abstract N2 - Doxorubicin (DOX) is one of the most effective anticancer drugs to treat various forms of cancers; however, its therapeutic utility is severely limited by its associated cardiotoxicity. Despite the enormous amount of research conducted in this area, the exact molecular mechanisms underlying DOX toxic effects on the heart are still an area that warrants further investigations. In this study, we reviewed literature to gather the best-known molecular pathways related to DOX-induced cardiotoxicity (DIC). They include mechanisms dependent on mitochondrial dysfunction such as DOX influence on the mitochondrial electron transport chain, redox cycling, oxidative stress, calcium dysregulation, and apoptosis pathways. Furthermore, we discuss the existing strategies to prevent and/or alleviate DIC along with various techniques available for therapeutic drug monitoring (TDM) in cancer patients treated with DOX. Finally, we propose a stepwise flowchart for TDM of DOX and present our perspective at curtailing this deleterious side effect of DOX. ER -