Advances in Cancer Treatment and Toxicity

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 10 March 2026 | Viewed by 723

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Guest Editor
Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
Interests: inflammation; heart; macrophages; cell death; doxorubicin
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Special Issue Information

Dear Colleagues,

Cancer drugs are commonly used to treat tumors. Unfortunately, most cancer drugs (doxorubicin, ponatinib, cisplatin, etc.) induce cardiomyopathy and muscle weakness as a side effect. The exact mechanisms of action of these drugs are far from clear; however, based on current research, it has been suggested that increased oxidative stress, inflammation, mitochondrial dysfunction and cell death are the prominent mechanisms involved in the development as well as progression of these diseases. Recent data suggest that researchers are investigating various therapeutic approaches, such as miRNA technology, antioxidative as well as anti-inflammatory drugs, antiapoptotic therapeutic options, cell therapy and exosomes.

Pharmaceuticals is organizing a Special Issue on the topic of cancer drug toxicity and interventions. In this Special Issue, we invite both original and review articles that cover the current concepts of anticancer-drug-induced toxicity in the heart and muscles. These articles can be of a wider scope, including topics such as oxidative stress, cell signaling, cell death, tissue remodeling, inflammation and other relevant molecular mechanisms that are involved in anticancer-drug-induced cardiac and muscle toxicity. We also welcome any current therapeutic strategies being investigated to attenuate anticancer-drug-induced side effects.

Prof. Dr. Dinender K. Singla
Guest Editor

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Keywords

  • oxidative stress
  • cell signaling
  • cell death
  • tissue remodeling
  • inflammation
  • molecular mechanisms
  • heart
  • muscle
  • antioxidants
  • cell therapy
  • exosomes

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Published Papers (2 papers)

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Research

17 pages, 2374 KB  
Article
Sex-Related Safety Signals of Sotorasib in Non-Small Cell Lung Cancer: A Real-World, Pharmacovigilance Study from the EudraVigilance Database
by Desirèe Speranza, Mariapia Marafioti, Martina Musarra, Vincenzo Cianci, Fausto Omero, Calogera Claudia Spagnolo, Marco Calabrò, Nicola Silvestris, Natasha Irrera and Mariacarmela Santarpia
Pharmaceuticals 2025, 18(10), 1574; https://doi.org/10.3390/ph18101574 - 19 Oct 2025
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Abstract
Background: Sotorasib, a KRAS G12C inhibitor, is approved for treating non-small cell lung cancer (NSCLC) and has shown a distinct safety profile in randomized clinical trials (RCTs). However, post-marketing pharmacovigilance is crucial to identify real-world safety signals including sex-specific differences that may [...] Read more.
Background: Sotorasib, a KRAS G12C inhibitor, is approved for treating non-small cell lung cancer (NSCLC) and has shown a distinct safety profile in randomized clinical trials (RCTs). However, post-marketing pharmacovigilance is crucial to identify real-world safety signals including sex-specific differences that may not be evident in controlled trial settings. Methods: This analysis reviewed 845 individual case safety reports (ICSRs) from the EudraVigilance (EV) database between 1 January 2021, and 8 April 2025, involving NSCLC patients treated with sotorasib. Adverse drug reactions (ADRs) were assessed by sex, seriousness, outcome, and system organ class (SOC). Disproportionality analyses were conducted to detect sex-specific safety signals, and results were compared with data from the CodeBreaK200 RCT by using a two-proportion z-test. Results: Among the ICSRs, 49.2% involved male and 40.1% female patients. Serious ADRs accounted for 47.5% of cases, with females at higher risk (relative risk [RR] = 1.31; 95% confidence interval (CI): 1.22–1.40; p < 0.0001). The most frequently reported SOCs were neoplasms (15.8%), gastrointestinal disorders (15.3%), and hepatobiliary disorders (11.5%). Four sex-specific safety signals were identified: women had a significantly increased risk of cholestasis (RR = 3.37) and hepatotoxicity (RR = 3.01), while men were less likely to report decreased appetite (RR = 0.20) and rash (RR = 0.14). Real-world data showed lower reporting of diarrhea, fatigue, nausea, and liver enzyme elevations (p < 0.0001). Conclusions: Real-world pharmacovigilance supports the RCT findings and highlights sex-specific risks, thus emphasizing the importance of sex-aware monitoring and personalized toxicity management. Full article
(This article belongs to the Special Issue Advances in Cancer Treatment and Toxicity)
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13 pages, 1501 KB  
Article
Predictive Value of Baseline Left Ventricular Global Longitudinal Strain for Cardiac Dysfunction in Patients with Moderate to High Risk of Cancer Therapy-Related Cardiovascular Toxicity
by Anna Borowiec, Patrycja Ozdowska, Magdalena Rosinska, Agnieszka Maria Zebrowska, Slawomir Jasek, Beata Kotowicz, Hanna Kosela-Paterczyk, Elzbieta Lampka, Zbigniew Nowecki and Jan Walewski
Pharmaceuticals 2025, 18(10), 1530; https://doi.org/10.3390/ph18101530 - 11 Oct 2025
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Abstract
Background: Anthracycline-based chemotherapy is associated with a risk of cancer therapy-related cardiac dysfunction (CTRCD), particularly in patients with moderate to high cardiovascular risk. Left ventricular global longitudinal strain (GLS) is a sensitive marker for early myocardial dysfunction, but the prognostic value of baseline [...] Read more.
Background: Anthracycline-based chemotherapy is associated with a risk of cancer therapy-related cardiac dysfunction (CTRCD), particularly in patients with moderate to high cardiovascular risk. Left ventricular global longitudinal strain (GLS) is a sensitive marker for early myocardial dysfunction, but the prognostic value of baseline GLS in this population remains unclear. Objective: We aimed to evaluate whether baseline GLS can predict CTRCD in moderate- to high-risk cancer patients undergoing anthracycline chemotherapy. Methods: In this prospective, single-center observational study, 80 anthracycline-naive cancer patients classified as moderate or high risk were enrolled. Baseline GLS was assessed via speckle-tracking echocardiography, with a threshold of ≥−18% considered decreased. Patients were followed for 12 months, and the primary endpoint was the development of CTRCD per ESC 2022 Cardio-oncology guidelines. Results: Of the 77 patients completing follow-up, 27.3% had decreased baseline GLS. CTRCD occurred in 62.4% of patients, with higher incidence among those with decreased GLS (76.7%) compared to those with normal GLS. In multivariable analysis, GLS ≥−18% was the only significant independent predictor of CTRCD (RR 12.0, 95% CI 2.0–71.9; p = 0.0065). All-cause mortality was also significantly higher in patients with decreased baseline GLS (19.1% vs. 1.8%, p = 0.018). Conclusions: Decreased baseline global longitudinal strain is an independent predictor of cancer therapy-related cardiac dysfunction and all-cause mortality in moderate- to high-risk patients receiving anthracycline therapy. These findings support the inclusion of baseline GLS in pre-treatment cardiovascular risk assessment, particularly in patients with an LVEF above 54%, to more effectively identify those who may benefit from early cardioprotective interventions. Full article
(This article belongs to the Special Issue Advances in Cancer Treatment and Toxicity)
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