Serra W, Fantin A, Longo C, Rabia G, De Rosa F, Plenteda C, Re F, Crisafulli E, Chetta A
Cardiology Unit, Department of Surgery, University of Parma, Parma, Italy.
Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Cardiovasc Hematol Disord Drug Targets. 2019;19(3):253-258. doi: 10.2174/1871529X19666181205100705.
Carfilzomib, a proteasome inhibitor, known as a therapeutical option for people who have already received one or more previous treatments for multiple myeloma, has well known cardiac and systemic adverse effects.
There is evidence supporting that adverse effects are dose dependent, yet there is no known patient phenotype characterized by worse associated consequences, nor are there widely accepted monitoring protocols.
In this article we describe two patients with cardiovascular adverse events related to carfilzomib treatment and their clinical course. Our goal was to present two cases of daily practice, which highlighted the complexity of their management and led to underline how baseline evaluation and close follow-up with echocardiography and cardiac biomarkers, including natriuretic peptides, remain an important tool for the cardiotoxicity surveillance.
These reflections should lead to further studies in order to identify high risk patients for cardiovascular adverse event and clarify the real incidence of cardiotoxicity of this drug and adequate follow-up timing. Finally further research is needed to evaluate strategies for prevention and attenuation of cardiovascular complications of cancer therapy.
卡非佐米是一种蛋白酶体抑制剂，是已接受过一种或多种多发性骨髓瘤先前治疗的患者的一种治疗选择，但其具有众所周知的心脏和全身不良反应。
有证据支持不良反应具有剂量依赖性，但尚无已知的以更严重相关后果为特征的患者表型，也没有广泛接受的监测方案。
在本文中，我们描述了两名与卡非佐米治疗相关的心血管不良事件患者及其临床病程。我们的目的是呈现两例日常病例，突出其管理的复杂性，并强调基线评估以及通过超声心动图和包括利钠肽在内的心脏生物标志物进行密切随访，仍然是心脏毒性监测的重要工具。
这些思考应促使进一步研究，以识别心血管不良事件的高危患者，明确该药物心脏毒性的实际发生率以及适当的随访时机。最后，需要进一步研究来评估预防和减轻癌症治疗心血管并发症的策略。
