Adriamycin (ADR)

an anthracycline drug

is widely used and clearly effective in the treatment of acute lymphoblastic leukemia

lung cancer

breast cancer and other diseases

with a broad anti-tumor spectrum. However

ADR shows extensive and severe toxicity. Especially

the accumulation of cardiac myocytes causes myocardial tissues more vulnerable to ADR

demonstrating an irreversible dose-dependent injury. Thus

the dosage of ADR is enormously limited in clinical applications. Meanwhile

the incidence and mortality of cardiovascular diseases in cancer survivors has been increased. It is believed that adriamycin-induced cardiotoxicity is the result of a variety of factors

such as the mass formation of reactive oxygen free radicals

calcium overload

mitochondrial damage

apoptosis and autophagy. These factors are interrelated and mutually causative

forming a vicious circulating network to jointly promote the development of their cardiotoxicity. So far

no single drug or method has been particularly effective in preventing adriamycin-induced cardiotoxicity

without reducing its anticancer efficacy. Therefore

it is still a severe challenge to find a safer and more effective drug or method to fight against adriamycin-induced cardiotoxicity. Many traditional Chinese medicines(TCM) with the characteristics of multiple targets and multiple effects

can antagonize adriamycin-induced cardiotoxicity by antioxidant stress

scavenging free radicals

regulation of calcium metabolism

protection of mitochondrial damage and antagonism of myocardial cell apoptosis. In recent years

lots of researches on TCM and their effective components in protection and reduction of adriamycin-induced cardiotoxicity have been reported and great progresses have been made for the researches on mechanism of action. This article reviews the research progresses on the application and mechanism of TCM and the effective components in the prevention and treatment of adriamycin-induced cardiotoxicity in the last ten years

in order to provide certain reference for safer and more reasonable clinical use of adriamycin combined with TCM.