Ederhy Stephane, Cohen Ariel, Dufaitre Ghislaine, Izzedine Hassan, Massard Christophe, Meuleman Catherine, Besse Benjamin, Berthelot Emmanuelle, Boccara Franck, Soria Jean-Charles
Cardiology Department, Saint-Antoine University and Medical School, Paris Cedex 12, France.
Target Oncol. 2009 Apr;4(2):89-97. doi: 10.1007/s11523-009-0111-3. Epub 2009 May 6.
Among toxicities associated with molecular targeted agents (MTA), cardiovascular toxicities remain largely unknown or underestimated. Their frequency is variable and dependent on the compound. A high incidence of hypertension, symptomatic or asymptomatic left ventricular systolic dysfunction, acute coronary syndrome, arterial and venous thrombosis has been observed in patients receiving MTA. One of the most threatening complications of angiogenic inhibitors (AI) could be QT prolongation with the risk of torsade de pointes (TdP) and sudden death. QT prolongation and torsade de pointes accounted for 29% of cardiac and non-cardiac post-marketing withdrawals. The assessment of the effects of drugs on cardiac repolarization is the subject of recent guidelines and recommendations. Regulatory agencies now require practically every new pharmaceutical compound to undergo a thorough investigation of its propensity to modify cardiac repolarization. To reduce the incidence of QT prolongation and torsade de pointes in patients receiving AI, cancer patients should be closely monitored while receiving AI.
在与分子靶向药物（MTA）相关的毒性中，心血管毒性在很大程度上仍不为人知或被低估。其发生率各不相同，且取决于具体的化合物。在接受MTA治疗的患者中，已观察到高血压、有症状或无症状的左心室收缩功能障碍、急性冠状动脉综合征、动脉和静脉血栓形成的发生率较高。血管生成抑制剂（AI）最具威胁性的并发症之一可能是QT间期延长，伴有尖端扭转型室性心动过速（TdP）和猝死风险。QT间期延长和尖端扭转型室性心动过速占心脏和非心脏药物上市后撤市原因的29%。评估药物对心脏复极化的影响是近期指南和建议的主题。监管机构现在几乎要求每一种新的药物化合物都要对其改变心脏复极化的倾向进行全面调查。为降低接受AI治疗患者的QT间期延长和尖端扭转型室性心动过速的发生率，癌症患者在接受AI治疗时应密切监测。
