Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV.
J Natl Cancer Inst. 2014 Sep 10;106(9). doi: 10.1093/jnci/dju232. Print 2014 Sep.
Cardiotoxicity resulting from direct myocyte damage has been a known complication of cancer treatment for decades. More recently, the emergence of hypertension as a clinically significant side effect of several new agents has been recognized as adversely affecting cancer treatment outcomes. With cancer patients living longer, in part because of treatment advances, these adverse events have become increasingly important to address. However, little is known about the cardiovascular pathogenic mechanisms associated with cancer treatment and even less about how to optimally prevent and manage short- and long-term cardiovascular complications, leading to improved patient safety and clinical outcomes. To identify research priorities, allocate resources, and establish infrastructure required to address cardiotoxicity associated with cancer treatment, the National Cancer Institute (NCI) and National Heart, Lung and Blood Institute (NHLBI) sponsored a two-day workshop, "Cancer treatment-related cardiotoxicity: Understanding the current state of knowledge and future research priorities," in March 2013 in Bethesda, MD. Participants included leading oncology and cardiology researchers and health professionals, patient advocates and industry representatives, with expertise ranging from basic to clinical science. Attendees were charged with identifying research opportunities to advance the understanding of cancer treatment-related cardiotoxicity across basic and clinical science. This commentary highlights the key discussion points and overarching recommendations from that workshop.
几十年来,直接损伤心肌细胞导致的心脏毒性一直是癌症治疗的已知并发症。最近,几种新型药物引起的高血压作为一种具有临床意义的副作用而出现,被认为会对癌症治疗结果产生不利影响。由于治疗进展,癌症患者的寿命更长,这些不良事件变得越来越重要,需要加以解决。然而,人们对与癌症治疗相关的心血管发病机制知之甚少,甚至更少了解如何最佳地预防和管理短期和长期心血管并发症,以提高患者安全性和临床结果。为了确定与癌症治疗相关的心脏毒性的研究重点、分配资源和建立基础设施,美国国家癌症研究所(NCI)和美国国家心肺血液研究所(NHLBI)于 2013 年 3 月在马里兰州贝塞斯达主办了为期两天的研讨会,题为“癌症治疗相关心脏毒性:了解当前知识状况和未来研究重点”。与会者包括领先的肿瘤学和心脏病学研究人员和医疗保健专业人员、患者权益维护者和行业代表,他们在基础和临床科学方面拥有从基础到临床的专业知识。与会者的任务是确定研究机会,以推进对癌症治疗相关心脏毒性的基础和临床科学的理解。本评论突出了该研讨会的主要讨论要点和总体建议。