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曲妥珠单抗、VEGF 和酪氨酸激酶抑制剂诱导心脏毒性的分子机制:最新综述。

The Molecular Mechanisms of Cardiotoxicity Induced by HER2, VEGF, and Tyrosine Kinase Inhibitors: an Updated Review.

机构信息

Department of Cardiology, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao, 266100, Shandong, China.

Department of Hematology, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong, China.

出版信息

Cardiovasc Drugs Ther. 2022 Jun;36(3):511-524. doi: 10.1007/s10557-021-07181-3. Epub 2021 Apr 13.

Abstract

AIM

In recent decades, there has been a revolutionary decrease in cancer-related mortality and an increase in survival due to the introduction of novel targeted drugs. Nevertheless, drugs targeting human epidermal growth factor receptor 2 (HER-2), angiogenesis, and other tyrosine kinases also come with unexpected cardiac side effects, including heart failure, hypertension, arterial thrombosis, and arrhythmias, and have mechanisms that are unlike those of classic chemotherapeutic agents. In addition, it is challenging to address some problems, as the existing guidelines need to be more specific, and further large-scale clinical trials and experimental studies are required to confirm the benefit of administering cardioprotective agents to patients treated with targeted therapies. Therefore, an improved understanding of cardiotoxicity becomes increasingly important to minimize the pernicious effects and maximize the beneficial effects of targeted agents.

METHODS

"Cardiotoxicity", "targeted drugs", "HER2", "trastuzumab", "angiogenesis inhibitor", "VEGF inhibitor" and "tyrosine kinase inhibitors" are used as keywords for article searches.

RESULTS

In this article, we report several targeted therapies that induce cardiotoxicity and update knowledge of the clinical evidence, molecular mechanisms, and management measures.

摘要

目的

近几十年来,由于新型靶向药物的引入,癌症相关死亡率大幅下降,生存率提高。然而,针对人表皮生长因子受体 2(HER-2)、血管生成和其他酪氨酸激酶的药物也会带来意想不到的心脏副作用,包括心力衰竭、高血压、动脉血栓形成和心律失常,其作用机制与经典化疗药物不同。此外,一些问题难以解决,因为现有的指南需要更加具体,还需要进一步进行大规模临床试验和实验研究,以确认给予心脏保护剂是否对接受靶向治疗的患者有益。因此,为了最大限度地减少靶向药物的有害影响并发挥其有益作用,提高对心脏毒性的认识变得越来越重要。

方法

以“心脏毒性”、“靶向药物”、“HER2”、“曲妥珠单抗”、“血管生成抑制剂”、“VEGF 抑制剂”和“酪氨酸激酶抑制剂”为关键词进行文章检索。

结果

本文报告了几种引起心脏毒性的靶向治疗方法,并更新了关于临床证据、分子机制和管理措施的知识。

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