Research progress on the prevention and treatment of drug-induced myocardial injury caused by anti-tumor therapy with Chinese herbal medicine

With the widespread application of chemotherapy, immunotherapy, and targeted therapies, cardiotoxicity associated with cancer treatment has gained increasing attention. Drug-induced cardiac injury can significantly impair patients’ quality of life and may even limit the overall efficacy of anticancer therapy. The underlying mechanisms involve multiple signaling pathways, including oxidative stress, inflammatory responses, mitochondrial dysfunction, apoptosis, and immune dysregulation. Owing to their multitarget effects, low toxicity, and holistic regulatory properties, traditional Chinese herbal medicines have demonstrated considerable potential in cardioprotection. This review summarizes the principal mechanisms of anticancer drug–induced myocardial injury and highlights recent advances in the prevention and treatment of cardiotoxicity using traditional Chinese medicine formulations, such as Compound Danshen Dripping Pills, Nuanxinkang, Qili Qiangxin Capsules, and Shengmai Powder, as well as their bioactive constituents. The cardioprotective effects of these agents are discussed in terms of their antioxidative, anti-inflammatory, immunomodulatory, and mitochondrial-protective actions. Furthermore, we highlight certain herbal medicines with intrinsic antitumor activity that exhibit unique advantages in synergistic cardioprotective and anticancer therapy. Future efforts should focus on well-designed, systematic clinical studies to facilitate the translational application of integrated Chinese and Western medicine in cardio-oncology.