Introduction: Anthracyclines are among the most powerful antineoplastic drugs ever developed and, even today, they are widely used according to various association schemes in the onco-hematological field. However, cardiotoxicity remains one of the most feared and characteristic side effects, both short and long term, often causing the premature interruption of therapy or irreversible effects after their suspension. In this article, we want to explain the underlying biological mechanisms, the clinical presentation characteristics and the possible strategies to prevent it.

Materials and Methods: A computerized research was carried out for the articles to be inserted through use of international databases PUBMED, RESEARCHGATE and GOOGLE SCHOLAR, by typing in keywords such as “anthracyclines cardiotoxicity” and “cardioprotection strategies for anthracycline toxicity” and related articles.

Discussion and Conclusions: The toxicity of these drugs on the heart represents the limiting factor both for their indications and for the success of the therapy, sometimes being the cause of premature interruption or impossibility of use in some patients. It depends especially on the cumulative dose used in the single patient and on the pre- existing risk conditions for the development of these ADRs, both in the short and long term. However, there are strategies that can avoid or reduce the damage, both related to the formulation of the compounds and to the co- administration of other drugs.