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Numerous therapeutic options exist for treating cancer, with chemotherapy being one of the most prominent. Chemotherapy involves the use of antineoplastic drugs, either alone or in combination with other medications, to target and kill cancer cells. However, these drugs can also adversely affect healthy cells, leading to various side effects. Among the most commonly used chemotherapy agents are anthracyclines, which include doxorubicin, daunorubicin, and epirubicin. Doxorubicin is particularly notable for its effectiveness but is also associated with significant cardiotoxicity, a common concern for patients undergoing chemotherapy. Unfortunately, there is currently no definitive treatment to prevent or reverse this cardiotoxicity. The cardiac effects of doxorubicin can manifest in several ways, including changes in electrocardiograms, arrhythmias, myocarditis, pericarditis, myocardial infarction, cardiomyopathy, heart failure, and congestive heart failure. These complications may arise during treatment, shortly after it concludes, or even weeks later. Various mechanisms have been proposed to explain doxorubicin\u2010induced cardiotoxicity. Key factors include the inhibition of topoisomerase II\u03b2, mitochondrial damage, reactive oxygen species (ROS) production due to iron metabolism, increased oxidative stress, heightened inflammatory responses, and elevated rates of apoptosis and necrosis within cardiac tissue. This review article will provide a comprehensive overview of the current state of knowledge regarding doxorubicin\u2010induced cardiomyopathy. We will explore the underlying molecular mechanisms contributing to this condition and discuss emerging therapeutic strategies aimed at mitigating its impact on cancer survivors.<\/jats:p>","DOI":"10.1002\/jbt.70155","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T09:29:08Z","timestamp":1738229348000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Managing Doxorubicin Cardiotoxicity: Insights Into Molecular Mechanisms and Protective Strategies"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4150-5279","authenticated-orcid":false,"given":"Adnan Taan","family":"Al khafaji","sequence":"first","affiliation":[{"name":"College of Medicine, Al\u2010Ayen Iraqi University  An Nasiriyah Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Mohammed","family":"Barakat","sequence":"additional","affiliation":[{"name":"College of Medicine, Al\u2010Ayen Iraqi University  An Nasiriyah Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram Joudah","family":"shayyal","sequence":"additional","affiliation":[{"name":"College of Medicine, Al\u2010Ayen Iraqi University  An Nasiriyah Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Adnan","family":"Taan","sequence":"additional","affiliation":[{"name":"Nasr City Hospital for Health Insurance, Ministry of Health  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed Fanoukh","family":"Aboqader Al\u2010Aouadi","sequence":"additional","affiliation":[{"name":"College of Medicine, Al\u2010Ayen Iraqi University  An Nasiriyah Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26333"},{"key":"e_1_2_12_3_1","first-page":"139","article-title":"An Overview of Cancer Treatment Modalities","volume":"1","author":"Abbas Z.","year":"2018","journal-title":"Neoplasm"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3892\/ijo.2018.4661"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4236\/jct.2014.58089"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbcan.2013.12.002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-74588-6_70"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvim.15414"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbi.2022.110028"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells11132000"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-9777-0_8"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.15275\/rusomj.2020.0305"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.020406"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2024.02.001"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/2162-3619-1-10"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2019.08.003"},{"key":"e_1_2_12_17_1","unstructured":"K.Johnson\u2010ArborandR.Dubey Doxorubicin inStatPearls. 2024 StatPearls Publishing Copyright \u00a9 2024 StatPearls Publishing LLC.: Treasure Island (FL) ineligible companies. 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