Protecting Hearts During Cancer Treatment: Remote Ischemic Conditioning Shows Promise
Advances in cancer treatment have led to increased survival rates, but some of the most effective chemotherapy drugs, particularly anthracyclines, can cause significant damage to the heart. This cardiac damage, sometimes appearing years after treatment completion, can severely impact a patient’s quality of life. Now, research suggests a simple, non-pharmacological technique called remote ischemic conditioning (RIC) may offer a way to protect the heart during cancer treatment without diminishing the chemotherapy’s effectiveness.
Understanding Anthracycline Cardiotoxicity
Anthracyclines are a cornerstone treatment for many cancers, including lymphomas, acute leukemias, and soft tissue sarcomas 1. Despite their efficacy, these drugs are known for their cardiotoxic effects. Cancer therapy-related cardiac dysfunction (CTRCD) is defined by decreases in left ventricular ejection fraction (LVEF) >10% to <50% and/or global longitudinal strain (GLS) >15% relative decrease from baseline 1. The risk of cardiotoxicity is dose-dependent, with higher cumulative doses posing a greater risk; a threshold between low and high heart failure risk is defined at 250-300 mg/m2 for doxorubicin 1.
How Remote Ischemic Conditioning Works
Remote ischemic conditioning (RIC) involves brief, controlled interruptions of blood flow to a limb, typically achieved using a blood pressure cuff. This process activates the body’s natural protective mechanisms, helping the heart better withstand stressors like chemotherapy-induced damage. The technique is non-invasive and doesn’t involve any medication.
New Research Demonstrates Cardioprotective Effects
A recent study published in Basic Research in Cardiology demonstrated the potential of RIC in protecting the heart during anthracycline treatment 2. Researchers used mice treated with anthracyclines to mimic the clinical situation in cancer patients. The results showed that animals receiving RIC maintained better cardiac function throughout treatment. Importantly, this cardioprotective effect did not interfere with the antitumor effectiveness of the chemotherapy 2.
Clinical Trials Underway
The findings from this experimental model are encouraging and support ongoing clinical trials. The European clinical trial RESILIENCE is currently evaluating whether RIC can protect the hearts of cancer patients undergoing anthracycline treatment and reduce the risk of long-term cardiovascular complications 2.
The Future of Cardio-Oncology
The field of cardio-oncology is dedicated to safeguarding the cardiovascular health of cancer patients 3. Researchers are exploring various strategies to minimize cardiac damage from cancer treatments, including preventive measures, risk factor control, and surveillance. The potential of simple, non-invasive techniques like RIC to improve the quality of life for cancer survivors is a promising development.
“Showing that the heart can be protected without compromising cancer treatment is essential to developing safer therapies,” explains Anabel Díaz Guerra, a researcher involved in the study 2.