Zhu Xiaolei, Wu Shenhong
Division of Primary Care, Department of Medicine, Renaissance School of Medicine at Stony Brook University, 205 North Belle Mead Road, NY, 11733, Stony Brook, USA.
Division of Hematology and Oncology, Department of Medicine, Renaissance School of Medicine at Stony Brook University, Lauterbur drive, NY, 11794, Stony Brook, USA.
Clin Hypertens. 2022 May 15;28(1):14. doi: 10.1186/s40885-022-00197-3.
Rapid progress over the last decade has added numerous agents targeting specific cellular signaling pathways to the treatment armamentarium for advanced cancer. However, many of these agents can cause hypertension resulting in major adverse cardiovascular event.
A systematic literature search was performed on the databases PubMed and Google Scholar for papers published in English until December 2020. This review summarizes the risk, mechanism, diagnosis, and management of hypertension in cancer patients undergoing targeted therapy. The risk and pathogenesis of hypertension vary widely with different classes of targeted agents. Currently there is a paucity of data investigating optimal management of hypertension with targeted therapy. A practical approach is discussed with a focus on the goal of blood pressure control as well as drug selection based on the mechanism of hypertension in the context of advanced cancer, treatment toxicity, comorbidity, and drug-drug interactions. This review also discusses many studies that have explored hypertension as a biomarker for cancer treatment efficacy and as a pharmacodynamic biomarker to titrate drug dose.
The diversity of targeted agents has provided important insights into the pathogenesis of hypertension in cancer patients. The underlying mechanism may provide a guidance to the management of hypertension. Further studies are needed to investigate optimal treatment and hypertension as a biomarker for cancer treatment.
在过去十年中，快速发展使得针对特定细胞信号通路的多种药物被添加到晚期癌症的治疗药物库中。然而，这些药物中的许多会导致高血压，进而引发重大不良心血管事件。
在PubMed和谷歌学术数据库中进行了系统的文献检索，以查找截至2020年12月以英文发表的论文。本综述总结了接受靶向治疗的癌症患者高血压的风险、机制、诊断和管理。高血压的风险和发病机制因不同类别的靶向药物而有很大差异。目前，关于靶向治疗高血压的最佳管理的数据很少。本文讨论了一种实用的方法，重点关注血压控制目标以及基于晚期癌症背景下高血压机制、治疗毒性、合并症和药物相互作用的药物选择。本综述还讨论了许多将高血压作为癌症治疗疗效生物标志物以及作为滴定药物剂量的药效学生物标志物进行探索的研究。
靶向药物的多样性为深入了解癌症患者高血压的发病机制提供了重要见解。潜在机制可能为高血压的管理提供指导。需要进一步研究以探讨最佳治疗方法以及将高血压作为癌症治疗的生物标志物。
