Cardiovascular toxicity of antineoplastic medicines in Bosnia and Herzegovina

Cancer and heart diseases are the leading causes of morbidity and mortality in many countries worldwide. Using chemotherapy and targeted therapies has led to an improvement in cancer survival rates and, unfortunately, higher cardiac adverse side effects – cardiotoxicity (Leong et al., 2019). Antineoplastic medicines have improved overall survival and progression-free survival to the oncological patients (Jemal et al., 2011; Varricchi et al., 2019). Mentioned medicines can be associated with several side effects, including cardiovascular toxicity. The National Cancer Institute defines cardiotoxicity in very general terms as “toxicity that affects the heart” (www.cancer.gov/dictionary/). Cardiotoxicity can develop in a subacute, acute, or chronic manner (Albini et al., 2018). Mitochondria are central targets for antineoplastic medicineinduced cardiovascular toxicity (Varricchi et al., 2019). Antineoplastic-related cardiovascular toxicities have been presented in many countries especially North American and European (Leong et al., 2019). Reported results from western countries are showed that the incidence rate of cancer treatment-induced cardiotoxicity is related with several chemotherapy and targeted therapies: anthracycline (0.9%–57%), cyclophosphamide (2%–28%), trastuzumab (0%– 28%) and bevacizumab (1.7%–10.9%) (Leong et al., 2019). The Agency for medicines and medical devices of Bosnia and Herzegovina (ALMBIH) was established by the Law on Drugs and Medical Devices ("Official Gazette of B&H, No. 58/08") as an authorized body for medicines and medical devices produced and used in B&H. In 2019. ALMBIH has become full member of Uppsala Monitoring Centre – World Health Organization. The aim of this work was to investigate the cardiovascular toxicity of antineoplastic medicines in Bosnia and Herzegovina.