Human In Vitro Models for Assessing the Genomic Basis of Chemotherapy-Induced Cardiovascular Toxicity

J Cardiovasc Transl Res. 2020 Jun;13(3):377-389. doi: 10.1007/s12265-020-09962-x. Epub 2020 Feb 20.

Abstract

Chemotherapy-induced cardiovascular toxicity (CICT) is a well-established risk for cancer survivors and causes diseases such as heart failure, arrhythmia, vascular dysfunction, and atherosclerosis. As our knowledge of the precise cardiovascular risks of each chemotherapy agent has improved, it has become clear that genomics is one of the most influential predictors of which patients will experience cardiovascular toxicity. Most recently, GWAS-led, top-down approaches have identified novel genetic variants and their related genes that are statistically related to CICT. Importantly, the advent of human-induced pluripotent stem cell (hiPSC) models provides a system to experimentally test the effect of these genomic findings in vitro, query the underlying mechanisms, and develop novel strategies to mitigate the cardiovascular toxicity liabilities due to these mechanisms. Here we review the cardiovascular toxicities of chemotherapy drugs, discuss how these can be modeled in vitro, and suggest how these models can be used to validate genetic variants that predispose patients to these effects.

Keywords: Cancer; Cardio-oncology; Cardiotoxicity; Human induced pluripotent stem cell; Precision medicine; Vascular toxicity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / toxicity*
  • Cardiotoxicity
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / genetics*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Cells, Cultured
  • Genetic Predisposition to Disease
  • Genetic Variation*
  • Genomics*
  • High-Throughput Screening Assays
  • Humans
  • Induced Pluripotent Stem Cells / drug effects*
  • Induced Pluripotent Stem Cells / metabolism
  • Induced Pluripotent Stem Cells / pathology
  • Mutation
  • Pharmacogenomic Variants
  • Phenotype
  • Polymorphism, Single Nucleotide
  • Risk Assessment
  • Risk Factors

Substances

  • Antineoplastic Agents