Revista de alergia y terapia

Abstracto

Dark Side of Cancer Therapy: Cancer Treatment Induced Cardiopulmonary Inflammation Fibrosis and Immune Modulation

Chellappagounder Thangavel

Advancements in cancer therapy increased the cancer free survival rates and reduced the malignant related deaths. Therapeutic options for patients with thoracic cancers include the surgical intervention and combination of chemotherapy with ionizing radiation. Despite these advances, Cancer Therapy-Related Cardiopulmonary Dysfunction (CTRCPD) is one of the most undesirable side effects of cancer therapy. Chemo-radiation therapy or immunotherapy promote acute and chronic cardiopulmonary damage by inducing reactive oxygen species, DNA damage, inflammation, fibrosis, altering cellular immunity, cardiopulmonary failure, and non-malignant related deaths among cancer-free patients. CTRCPD is a complex entity with multiple factors involved in this pathogenesis. Although the mechanisms of cancer therapy induced toxicities are multifactorial, damage to the cardiac and pulmonary tissue and subsequent fibrosis seem to be the underlying event. The available biomarkers at present are not sufficient and efficient to detect cancer therapy induced early asymptomatic cardiopulmonary fibrosis, Application of omics technology such us whole exome sequencing, protein mass spectrometry and single cell transcriptomics are warranted to identify early and late toxicity response biomarkers. In this review, we summarize the current state of knowledge on the cardiopulmonary complications of cancer therapy and our current understanding of the pathological and molecular consequences of cancer therapy-induced cardiopulmonary toxicity, inflammation, and immune modulation.