Heart Protection During Chemotherapy Achieved Without Reducing Cancer Treatment Effectiveness

A team at the Centro Nacional de Investigaciones Cardiovasculares (CNIC) has demonstrated in an experimental model that the heart can be protected during anthracycline treatment using a simple, non-pharmacological technique known as remote ischemic conditioning (RIC), without reducing chemotherapy's antitumor effectiveness. The study was published in Basic Research in Cardiology on February 13, 2026.

Advances in cancer treatment mean that more people than ever are surviving the disease. However, some of the most effective anticancer drugs—a class of medicines called anthracyclines—can cause serious damage to the heart. In some patients, this cardiac damage appears months or even years after treatment and has a major impact on quality of life.

RIC consists of controlled, brief interruptions of blood flow to a limb, usually achieved by applying a pressure cuff similar to those used to measure blood pressure. This stimulus activates protective mechanisms in the body that help the heart better withstand subsequent stressors, such as the damage caused by certain cancer treatments.

In the study, the researchers used anthracycline-treated, tumor-bearing mice to model the clinical situation in cancer patients. The results show that animals receiving RIC maintained better cardiac function during treatment. Importantly, this cardioprotective effect was not associated with increased tumor growth or reduced antitumor efficacy of chemotherapy.

"Showing that the heart can be protected without compromising cancer treatment is essential to developing safer therapies," said Anabel Díaz Guerra, a CNIC predoctoral researcher funded by the Spanish Association Against Cancer (AECC) and the study's first author.

These results align with the translational vision of the group led by the CNIC Scientific Director and cardiologist at Fundación Jiménez Díaz, who is currently coordinating the European clinical trial RESILIENCE. The trial is evaluating whether RIC can protect the hearts of cancer patients treated with anthracyclines and reduce long-term cardiovascular complications.

A senior CNIC investigator and co-supervisor noted that the findings "reinforce the idea that simple, non-invasive strategies can play a key role in cardiovascular protection for cancer patients and open new avenues to improve their quality of life during and after treatment."

Through its Myocardial Homeostasis and Cardiac Damage Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC) investigates the cardiovascular toxicity of cancer treatments, particularly the damage caused by anthracyclines, with the aim of developing effective and safe therapies.

Chemotherapy is one of the most common weapons in the cancer-treatment arsenal, but its side effects are well known. Hair loss, nausea and vomiting, mouth sores, and fatigue are common. The side effects a person with cancer may have are affected by the type of cancer being treated and the chemotherapy drug being used.

"Chemotherapy does work," said Dr. Ting Bao, a cancer specialist at the Dana-Farber Cancer Institute in Boston. "There are side effects, but they are becoming more and more manageable."

Chemo uses drugs to kill cancer cells or stop their growth. Side effects emerge when normal body cells are caught in the crossfire. Some cells multiply fast, such as those lining the intestines or those involved in hair growth. Chemo drugs can kill these cells, too.

Chemo can also lower the number of white blood cells available to fight off disease, putting patients at increased risk of infection. Some chemo drugs also cause neuropathy that leads to pain, tingling, numbness and balance problems.

As researchers explore new ways to reduce chemo's side effects, some tools in the present-day arsenal include anti-nausea drugs to help with nausea and vomiting, dietary changes to manage nausea, fatigue and mouth sores, exercise and good sleep habits to fight fatigue, and medication to address some kinds of chemo-related pain. Based on a patient's symptoms, doctors can recommend which strategies might help most.

Some are investigating whether herbal remedies, like ginger, may help with nausea. Bao is investigating whether acupuncture and yoga may help treat the chemo-induced neuropathy. "These ancient modalities intrigue me because they don't have much side effects," she said. "For acupuncture, the most common side effects are a little bruising and bleeding. And for yoga, joint and muscle pain." Trials are ongoing.

Other researchers are trying to understand the underpinnings of chemo-related neuropathy and testing drug treatments.

The CNIC is an affiliate center of the Carlos III Health Institute (ISCIII), an executive agency of the Spanish Ministry of Science, Innovation, and Universities. The CNIC has been recognized by the Spanish government as a Severo Ochoa center of excellence (award CEX2020-001041-S, funded by MICIN/AEI/10.13039/501100011033).