Current Applications of Chemotherapy in Treatment of Cardiac Cancers

Malignant cardiac tumors invite challenges to the efficacy of their treatment. Outside of their benign counterparts, malignant primary cardiac tumors - particularly sarcomas - necessitate approaches that involve a combination of treatments. One of those treatments, chemotherapy, is effective as both an adjuvant and palliative treatment, and its administration in tandem with either radiotherapy or surgical resection has contributed to greater rates of post-treatment survival. Most notably, reductions in tumor size prior to resection have been demonstrated by neoadjuvant chemotherapy in order to improve surgical outcomes. Showing promise in further increases of survival rates advances in chemotherapeutics such as anthracyclines and ifosfamide have established greater efficacy in clinical trials. However, factors like cardiotoxicity from the utilization of chemotherapy and the anatomical barriers of the heart hinder the effectiveness of the application of these new therapeutics. Outside of these limitations, the nature of late-stage diagnosis and patient age play a role in limiting the efficacy of chemotherapy. To limit the side effects of pharmaceuticals, there is a need for cardioprotective strategies and the development of targeted therapies; personalized and multimodal approaches to improve patient outcomes would be optimal as well. As more pharmaceuticals in chemotherapy are developed, future research into the chronic effects of the administration of the pharmaceuticals and alternative therapeutic avenues should be enacted.