Ruoyu Jin,1,2,* Qianhui You,1,* Chenshi Li,3,* Na Zhao,4 Chengyao Jia,5 Chinying Koo,2 Weiwei Zhang,2 Baonian Liu,2 Kaijian Huang1 

1Department of Cardiology, Qidong People’s Hospital/Qidong Liver Cancer Institute/Affiliated Qidong Hospital of Nantong University, Qidong, Jiangsu, 226200, People’s Republic of China; 2Department of Anatomy, School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China; 3School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, People’s Republic of China; 4Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China; 5Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Baonian Liu, Department of Anatomy, School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China, Email bnliu15@fudan.edu.cn Kaijian Huang, Department of Cardiology, Qidong People’s Hospital/Qidong Liver Cancer Institute/Affiliated Qidong Hospital of Nantong University, Qidong, 568 Minle Middle Road, Jiangsu, 226200, People’s Republic of China, Email 420185672@qq.com

Abstract: Cancer therapy-induced cardiotoxicity (CTIC) is a serious and increasingly recognized cause of death and disability among cancer survivors. It frequently necessitates the withdrawal or dose reduction of effective anticancer drugs, limiting therapeutic options and affecting patient outcomes. While CTIC poses a major health risk, the precise cellular and molecular mechanisms responsible for this toxicity remain elusive, which complicates the development of preventive and therapeutic strategies. In recent years, natural products derived from Traditional Chinese Medicine (TCM) have gained attention as potentially beneficial agents for CTIC management. These TCM natural products consist of biologically active compounds that often act on multiple therapeutic targets, offering a comprehensive approach to mitigating cardiotoxicity during cancer treatment. This review aims to provide a concise overview of CTIC associated with various anticancer drugs and examine the emerging research on TCM natural products in reducing the cardiotoxic effects related to cancer therapies, highlighting areas where further investigation is needed. In addition, we also provide the challenges and coping strategies faced by basic research and clinical transformation of Chinese medicine monomers.

Keywords: traditional chinese medicine, cancer therapy-induced cardiotoxicity, cardio-oncology, natural products, therapeutic agents