Beth Israel Deaconess Medical Center, 3 Blackfan Circle, CLS-917H, Boston, MA, 02115, USA.
Harvard Medical School, Boston, MA, 02115, USA.
Curr Cardiol Rep. 2018 May 25;20(7):52. doi: 10.1007/s11886-018-1002-y.
In this article, we review current and emerging approaches to biomarker discovery to facilitate early diagnosis of cancer therapy-associated cardiovascular toxicity.
Although small studies have demonstrated an association between established biomarkers of cardiac injury (troponins and brain natriuretic peptide) and acute or subacute cardiotoxicity, there is insufficient evidence to support their use in routine clinical care. Preclinical studies to define the molecular mechanisms of cardiotoxicity, as well as the use of unbiased "omics" techniques in small patient cohorts, have yielded promising candidate biomarkers that have the potential to enrich current risk stratification algorithms. New biomarkers of cardiotoxicity have the potential to improve patient outcomes in cardio-oncology. Further studies are needed to assess the clinical relevance of molecular mechanisms described in animal models. Similarly, findings from "omics" platforms require validation in large patient cohorts before they can be incorporated into everyday practice.
本文回顾了当前和新兴的生物标志物发现方法,以促进癌症治疗相关心血管毒性的早期诊断。
虽然小型研究已经证明了心脏损伤的既定生物标志物(肌钙蛋白和脑利钠肽)与急性或亚急性心脏毒性之间存在关联,但没有足够的证据支持它们在常规临床护理中的使用。为了定义心脏毒性的分子机制,以及在小患者队列中使用无偏的“组学”技术,已经产生了有前途的候选生物标志物,这些标志物有可能丰富当前的风险分层算法。新的心脏毒性生物标志物有可能改善心脏肿瘤学患者的预后。需要进一步的研究来评估在动物模型中描述的分子机制的临床相关性。同样,“组学”平台的发现需要在大型患者队列中进行验证,然后才能将其纳入日常实践。