Romitan Dragoș-Mihai, Rădulescu Dan, Berindan-Neagoe Ioana, Stoicescu Laurențiu, Grosu Alin, Rădulescu Liliana, Gulei Diana, Ciuleanu Tudor-Eliade
Department of Cardiology, Municipal Clinical Hospital of Cluj-Napoca, 400139 Cluj-Napoca, Romania.
Research Center for Functional Genomic, Biomedicine and Translational Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania.
Biomedicines. 2020 Nov 12;8(11):496. doi: 10.3390/biomedicines8110496.
Cardiology and oncology are two fields dedicated to the study of various types of oncological and cardiac diseases, but when they collide, a new specialty is born, i.e., cardio-oncology. Continuous research on cancer therapy has brought into the clinic novel therapeutics that have significantly improved patient survival. However, these therapies have also been associated with adverse effects that can impede the proper management of oncological patients through the necessity of drug discontinuation due to life-threatening or long-term morbidity risks. Cardiovascular toxicity from oncological therapies is the main issue that needs to be solved. Proper knowledge, interpretation, and management of new drugs are key elements for developing the best therapeutic strategies for oncological patients. Upon continuous investigations, the profile of cardiotoxicity events has been enlarged with the inclusion of myocarditis upon administration of immune checkpoint inhibitors and cardiac dysfunction in the context of cytokine release syndrome with chimeric antigen receptor T cell therapy. Affinity enhanced and chimeric antigen receptor T cells have both been associated with hypotension, arrhythmia, and left ventricular dysfunction, typically in the setting of cytokine release syndrome. Therefore, the cardiologist must adhere to the progressing field of cancer therapy and become familiar with the adverse effects of novel drugs, and not only the ones of standard care, such as anthracycline, trastuzumab, and radiation therapy. The present review provides essential information summarized from the latest studies from cardiology, oncology, and hematology to bring together the three specialties and offers proper management options for oncological patients.
心脏病学和肿瘤学是两个致力于研究各种肿瘤和心脏疾病的领域，但当它们相互碰撞时，一个新的专业领域便诞生了，即心脏肿瘤学。对癌症治疗的持续研究已将新的治疗方法引入临床，这些方法显著提高了患者的生存率。然而，这些治疗方法也伴随着不良反应，由于存在危及生命或长期发病风险而需要停药，这可能会妨碍肿瘤患者的妥善管理。肿瘤治疗引起的心血管毒性是需要解决的主要问题。对新药有恰当的认识、解读和管理是为肿瘤患者制定最佳治疗策略的关键要素。经过持续研究，心脏毒性事件的范围有所扩大，包括使用免疫检查点抑制剂时出现的心肌炎以及嵌合抗原受体T细胞疗法引发的细胞因子释放综合征背景下的心脏功能障碍。亲和力增强的嵌合抗原受体T细胞和普通嵌合抗原受体T细胞都与低血压、心律失常和左心室功能障碍有关，通常发生在细胞因子释放综合征的情况下。因此，心脏病专家必须紧跟癌症治疗这一不断发展的领域，熟悉新药的不良反应，而不仅仅是标准治疗药物（如蒽环类药物、曲妥珠单抗和放射治疗）的不良反应。本综述总结了心脏病学、肿瘤学和血液学最新研究的重要信息，将这三个专业领域整合在一起，并为肿瘤患者提供了恰当的管理方案。
