Huang Wei, Xu Rong, Zhou Bin, Lin Chao, Guo Yingkun, Xu Huayan, Guo Xia
Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China.
Laboratory of Molecular Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Center for Translational Medicine, Ministry of Education, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Cardiovasc Med. 2022 Jun 10;9:912329. doi: 10.3389/fcvm.2022.912329. eCollection 2022.
The development of various antitumor drugs has significantly improved the survival of patients with cancer. Many first-line chemotherapy drugs are cytotoxic and the cardiotoxicity is one of the most significant effects that could leads to poor prognosis and decreased survival rate. Cancer treatment include traditional anthracycline drugs, as well as some new targeted drugs such as trastuzumab and ICIs. These drugs may directly or indirectly cause cardiovascular injury through different mechanisms, and lead to increasing the risk of cardiovascular disease or accelerating the development of cardiovascular disease. Cardiotoxicity is clinically manifested by arrhythmia, decreased cardiac function, or even sudden death. The cardiotoxicity caused by traditional chemotherapy drugs such as anthracyclines are significantly known. The cardiotoxicity of some new antitumor drugs such like immune checkpoint inhibitors (ICIs) is also relatively clear and requiring further observation and verification. This review is focused on major three drugs with relatively high incidence of cardiotoxicity and poor prognosis and intended to provide an update on the clinical complications and outcomes of these drugs, and we innovatively summarize the monitoring status of survivors using these drugs and discuss the biomarkers and non-invasive imaging features to identify early cardiotoxicity. Finally, we summarize the prevention that decreasing antitumor drugs-induced cardiotoxicity.
各种抗肿瘤药物的发展显著提高了癌症患者的生存率。许多一线化疗药物具有细胞毒性,心脏毒性是其中最显著的影响之一,可导致预后不良和生存率降低。癌症治疗包括传统的蒽环类药物,以及一些新型靶向药物,如曲妥珠单抗和免疫检查点抑制剂(ICIs)。这些药物可能通过不同机制直接或间接导致心血管损伤,增加心血管疾病风险或加速心血管疾病的发展。心脏毒性在临床上表现为心律失常、心功能下降甚至猝死。蒽环类等传统化疗药物引起的心脏毒性已广为人知。一些新型抗肿瘤药物如免疫检查点抑制剂(ICIs)的心脏毒性也相对明确,需要进一步观察和验证。本综述重点关注心脏毒性发生率相对较高且预后较差的三种主要药物,旨在提供这些药物临床并发症和结局的最新情况,我们创新性地总结了使用这些药物的幸存者的监测状况,并讨论了用于识别早期心脏毒性的生物标志物和非侵入性成像特征。最后,我们总结了降低抗肿瘤药物所致心脏毒性的预防措施。