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表皮生长因子受体(EGFR)酪氨酸激酶抑制剂和单克隆抗体疗法的心血管风险

Cardiovascular Risks with Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors and Monoclonal Antibody Therapy.

作者信息

Chitturi Kalyan R, Burns Ethan A, Muhsen Ibrahim N, Anand Kartik, Trachtenberg Barry H

机构信息

Division of Cardiovascular Medicine, Department of Medicine, University of Missouri, 1 Hospital Drive, Columbia, MO, CE30665201, USA.

Houston Methodist Cancer Center, 6445 Main St. Outpatient Center, Floor 24, Houston, TX, 77030, USA.

出版信息

Curr Oncol Rep. 2022 Apr;24(4):475-491. doi: 10.1007/s11912-022-01215-1. Epub 2022 Feb 22.

Abstract

PURPOSE OF REVIEW

Tyrosine kinase inhibitors (TKI) and monoclonal antibodies (mAbs) that target the epidermal growth factor receptor (EGFR) have changed the therapeutic landscape across a range of solid malignancies. However, there is little data regarding the cardiovascular (CV) impact of these agents. The purpose of this review is to discuss reported CV effects, pathophysiology, pre-treatment screening, diagnostic workup, and treatment recommendations in this patient population.

RECENT FINDINGS

It is apparent that CV events are not class dependent, and while infrequently reported in clinical trials, unique CV toxicity may occur with EGFR inhibitors, including structural, electrical, and vascular events. There remains an unmet need to fully elucidate the spectrum of CV events associated with EGFR inhibitors. Early CV screening, close clinical monitoring, coupled with a multidisciplinary approach between medical and cardio-oncology is needed to minimize the potentially detrimental impact of cardiotoxicity in this patient population.

摘要

综述目的

靶向表皮生长因子受体(EGFR)的酪氨酸激酶抑制剂(TKI)和单克隆抗体(mAb)已经改变了多种实体恶性肿瘤的治疗格局。然而,关于这些药物对心血管(CV)影响的数据很少。本综述的目的是讨论该患者群体中已报道的心血管效应、病理生理学、治疗前筛查、诊断检查以及治疗建议。

最新发现

显然,心血管事件并非与药物类别相关,虽然在临床试验中报告较少,但表皮生长因子受体抑制剂可能会出现独特的心血管毒性,包括结构、电活动和血管方面的事件。仍有未满足的需求来全面阐明与表皮生长因子受体抑制剂相关的心血管事件谱。需要进行早期心血管筛查、密切的临床监测,以及医学和心脏肿瘤学之间的多学科方法,以尽量减少心脏毒性对该患者群体的潜在不利影响。

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