Ng Raymond, Green Michael D
Princess Margaret Hospital, Department of Medical Oncology, Toronto, Canada.
Expert Opin Drug Saf. 2007 May;6(3):315-21. doi: 10.1517/14740338.6.3.315.
Anthracyclines are among the most active chemotherapeutic agents in cancer treatment. Although infrequent, cumulative dose-dependent cardiotoxicity is nevertheless a significant side effect of this therapy resulting in reduced cardiac reserve or even frank cardiac failure. Although used in several types of malignancy, anthracyclines are most commonly used in breast cancer treatment. Importantly, recent advances have also seen the increasing use of another cardiotoxic agent, the monoclonal antibody trastuzumab, both in the metastatic as well as in the adjuvant breast cancer setting. This review discusses the relationship of cardiotoxicity and anthracycline use, particularly in the breast cancer setting, and explores available treatment options for the anthracycline-treated patients based on evidence from recent Phase III trials.
蒽环类药物是癌症治疗中最有效的化疗药物之一。尽管这种情况并不常见,但累积剂量依赖性心脏毒性仍是该疗法的一种显著副作用,会导致心脏储备功能下降甚至出现明显的心衰。尽管蒽环类药物用于多种恶性肿瘤,但最常用于乳腺癌治疗。重要的是,最近的进展还表明,另一种具有心脏毒性的药物——单克隆抗体曲妥珠单抗,在转移性乳腺癌以及辅助性乳腺癌治疗中的使用也越来越多。本综述讨论了心脏毒性与蒽环类药物使用之间的关系,特别是在乳腺癌治疗中的关系,并根据最近III期试验的证据探讨了蒽环类药物治疗患者可用的治疗选择。