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探讨现代抗癌疗法的心血管副作用。

Insights into cardiovascular side-effects of modern anticancer therapeutics.

出版信息

Curr Opin Oncol. 2010 Jul;22(4):312-7. doi: 10.1097/CCO.0b013e32833ab6f1.

Abstract

PURPOSE OF REVIEW

Modern anticancer therapeutics can be associated with significant cardiovascular side-effects. Detection, risk assessment, and treatment of these unwanted effects are an important task for treating physicians. The purpose of this review is to focus on approved novel cancer therapeutics and discuss the most important cardiovascular side-effects, prognosis, and potential treatment. We will contrast these effects to those of conventional cardiotoxic chemotherapeutics.

RECENT FINDINGS

Modern anticancer therapeutics can cause cardiovascular ischemia, arrhythmias, cardiac dysfunction, heart failure, and arterial hypertension. Anti-HER2 drugs, or more specifically trastuzumab, can induce cardiac dysfunction and heart failure. Newer data show that these effects occur predominantly during treatment and patients who experience the side-effects often have a good cardiovascular prognosis. Antiangiogenic agents can induce arterial hypertension, arterial and venous thromboembolism, and less frequently QTc prolongation. Recent findings indicate that a high rate of patients treated with antivascular endothelial growth factor drugs develop arterial hypertension and may experience related complications. Preventive strategies or optimal treatment have been tested but controlled studies are missing.

SUMMARY

Cardiovascular side-effects of modern anticancer drugs can be a serious problem and need careful attention, prevention, or treatment.

摘要

目的综述

现代抗癌疗法可能会引起严重的心血管副作用。发现、评估风险和治疗这些不良反应是治疗医生的一项重要任务。本文的目的是重点关注已批准的新型癌症治疗药物,并讨论最重要的心血管副作用、预后和潜在治疗方法。我们将把这些影响与传统的心脏毒性化疗药物进行对比。

最近的发现

现代抗癌疗法可引起心血管缺血、心律失常、心功能障碍、心力衰竭和高血压。抗 HER2 药物,更具体地说是曲妥珠单抗,可引起心功能障碍和心力衰竭。最新数据表明,这些作用主要发生在治疗期间,出现副作用的患者通常具有良好的心血管预后。抗血管生成药物可引起高血压、动静脉血栓栓塞,以及较少见的 QTc 延长。最近的研究结果表明,接受抗血管内皮生长因子药物治疗的患者中,高血压的发生率较高,并且可能会出现相关并发症。已经测试了预防策略或最佳治疗方法,但缺乏对照研究。

总结

现代抗癌药物的心血管副作用可能是一个严重的问题,需要仔细关注、预防或治疗。

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