用于胃肠道间质瘤的酪氨酸激酶抑制剂的心血管效应。

Cardiovascular effects of tyrosine kinase inhibitors used for gastrointestinal stromal tumors.

作者信息

Chintalgattu Vishnu, Patel Shalin S, Khakoo Aarif Y

机构信息

Department of Cardiology, University of Texas, M.D. Anderson Cancer Center, Institute of Biosciences and Technology, Room 718, 2121 West Holcombe Boulevard, Houston, TX 77030, USA.

出版信息

Hematol Oncol Clin North Am. 2009 Feb;23(1):97-107, viii-ix. doi: 10.1016/j.hoc.2008.11.004.

DOI:10.1016/j.hoc.2008.11.004

PMID:19248973

Abstract

Small-molecule tyrosine kinase inhibitors (TKIs) have revolutionized the targeted treatment of various cancers, including gastrointestinal stromal tumors (GISTs). Recent evidence suggests the possibility of cardiotoxicity secondary to TKI treatment of GISTs. Preclinical studies indicate that imatinib and sunitinib may be directly toxic to cardiac myocytes. Clinically, cardiotoxicity attributable to imatinib seems to be infrequent and manageable, whereas that attributable to sunitinib is more common and more severe. Further prospective studies with objective cardiac monitoring and long-term follow up are needed to define more accurately the incidence, natural history, and risk factors for developing cardiotoxicity associated with TKIs used in the treatment of patients who have GISTs. In this review, the authors discuss what is known regarding the cardiovascular effects of TKIs used in the treatment of GISTs.

摘要

小分子酪氨酸激酶抑制剂（TKIs）彻底改变了包括胃肠道间质瘤（GISTs）在内的各种癌症的靶向治疗。最近的证据表明，GISTs患者接受TKI治疗后可能出现心脏毒性。临床前研究表明，伊马替尼和舒尼替尼可能对心肌细胞具有直接毒性。在临床上，伊马替尼所致的心脏毒性似乎并不常见且易于控制，而舒尼替尼所致的心脏毒性则更为常见且更为严重。需要进一步进行客观心脏监测和长期随访的前瞻性研究，以更准确地确定接受GISTs治疗的患者使用TKIs后发生心脏毒性的发生率、自然病程和危险因素。在这篇综述中，作者讨论了关于用于治疗GISTs的TKIs的心血管效应的已知情况。