Heckmann Markus B, Doroudgar Shirin, Katus Hugo A, Lehmann Lorenz H
Department of Cardiology, Angiology, and Pneumology, Internal Medicine III, University Hospital Heidelberg, 69120 Heidelberg, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, 69120 Heidelberg, Germany.
J Thorac Dis. 2018 Dec;10(Suppl 35):S4296-S4305. doi: 10.21037/jtd.2018.09.87.
Multiple myeloma is a malignant disease, caused by an uncontrolled clonal proliferation of a specific group of white blood cells, the plasma cells. Clinical manifestations include bone pain due to osteolysis, hypercalcemia, anemia, and renal insufficiency. Proteasome inhibitors have substantially improved survival of patients suffering from multiple myeloma, providing an efficient treatment option mainly for relapsed and refractory multiple myeloma. Although constituting one substance class, bortezomib, carfilzomib, and ixazomib differ greatly regarding their non-hematologic side effects. This article reviews the clinical and preclinical data on approved proteasome inhibitors in an attempt to decipher the underlying pathomechanisms related to cardiovascular adverse events seen in clinical trials.
多发性骨髓瘤是一种恶性疾病,由特定的一组白细胞即浆细胞不受控制的克隆性增殖引起。临床表现包括溶骨性骨痛、高钙血症、贫血和肾功能不全。蛋白酶体抑制剂显著提高了多发性骨髓瘤患者的生存率,主要为复发和难治性多发性骨髓瘤提供了一种有效的治疗选择。虽然硼替佐米、卡非佐米和伊沙佐米属于同一类物质,但它们的非血液学副作用差异很大。本文综述了已获批蛋白酶体抑制剂的临床和临床前数据,试图解读与临床试验中所见心血管不良事件相关的潜在发病机制。