Courand Pierre-Yves, Berger Mathilde, Bouali Anissa, Harbaoui Brahim, Lantelme Pierre, Dalle Stéphane
Fédération de Cardiologie, Hôpital de La Croix-Rousse Et Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France.
Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France.
Curr Oncol Rep. 2022 Mar;24(3):265-271. doi: 10.1007/s11912-022-01205-3. Epub 2022 Feb 1.
The identification of BRAF mutation prompted the development of new class of targeted therapy for treating melanoma: BRAF inhibitors and MEK inhibitors. Cardiovascular events have been reported with these treatments and could counterbalance their long-term maintenance.
LVEF decrease due to BRAF and MEK inhibitors appears fairly common (10%) but usually not severe, without impact on patient outcomes. To date, no treatment options have been tested to prevent or to treat a decrease of LVEF associated with BRAF and MEK inhibitors. QTc prolongation was observed in 3% and arterial hypertension in 20% during treatment but only one-third of cases required a therapeutic change. BRAF and MEK inhibitors have revolutionized the management and the prognosis of melanoma patients. Cardio-oncology units may be useful for a better care of potential cardiac toxicity and particularly to inappropriately avoid discontinuing BRAF and MEK inhibitors.
BRAF 突变的发现促使开发出用于治疗黑色素瘤的新型靶向疗法：BRAF 抑制剂和 MEK 抑制剂。这些治疗方法已报告有心血管事件发生，这可能会抵消它们的长期维持效果。
BRAF 和 MEK 抑制剂导致的左心室射血分数（LVEF）降低似乎相当常见（10%），但通常并不严重，对患者预后没有影响。迄今为止，尚未对任何治疗方案进行测试以预防或治疗与 BRAF 和 MEK 抑制剂相关的 LVEF 降低。治疗期间观察到 3% 的患者出现 QTc 延长，20% 的患者出现动脉高血压，但只有三分之一的病例需要改变治疗方法。BRAF 和 MEK 抑制剂彻底改变了黑色素瘤患者的治疗和预后。心脏肿瘤学单元可能有助于更好地处理潜在的心脏毒性，特别是避免不恰当地停用 BRAF 和 MEK 抑制剂。
