Department of Oncology, Medical University of Vienna, Vienna, Austria.
Int J Urol. 2012 Sep;19(9):796-804. doi: 10.1111/j.1442-2042.2012.03033.x. Epub 2012 May 14.
Targeted agents have significantly improved outcomes in patients with metastatic renal cell carcinoma, and are changing long-term expectations in these patients. Experience with these agents highlights a distinct safety and tolerability profile, differing from that observed with conventional chemotherapy and radiotherapy. Cardiovascular adverse events have been observed when treating with targeted agents. This is of particular importance for patients with metastatic renal cell carcinoma who are elderly and present with significant comorbidities. A multidisciplinary approach and close collaboration between oncologists and cardiologists is essential for optimal management of cardiovascular adverse events. Strategies for the management of these adverse events include assessment of cardiovascular status at baseline and at regular intervals, patient education, and the use of supportive medication. Effective therapy management allows patients with cardiovascular adverse events to receive and continue targeted therapy with careful monitoring. Implementation of therapy management measures contributes towards maximizing treatment outcomes with targeted agents in patients with metastatic renal cell carcinoma.
靶向药物显著改善了转移性肾细胞癌患者的预后,并改变了这些患者的长期预期。这些药物的应用经验突出了其独特的安全性和耐受性特征,与传统化疗和放疗观察到的不同。在使用靶向药物治疗时,已经观察到心血管不良事件。对于患有转移性肾细胞癌且年龄较大、存在严重合并症的患者,这一点尤为重要。肿瘤学家和心脏病学家之间的多学科方法和密切合作对于最佳管理心血管不良事件至关重要。这些不良事件管理策略包括在基线和定期评估心血管状况、患者教育以及使用支持性药物。有效的治疗管理允许心血管不良事件患者在密切监测下接受并继续靶向治疗。实施治疗管理措施有助于最大限度地提高转移性肾细胞癌患者使用靶向药物的治疗效果。