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靶向抗肿瘤药物所致心脏毒性的机制与治疗

The mechanism and treatment of targeted anti-tumour drugs induced cardiotoxicity.

作者信息

Zhang Xiao, Gao Yiqiang, Yang Benyu, Ma Siqing, Zuo Wei, Wei Junji

机构信息

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Department of Pharmacy, State Key Laboratory of Complex Sever and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; School of Pharmacy, Tianjin University of Traditional Chinese Medicine, China.

出版信息

Int Immunopharmacol. 2023 Apr;117:109895. doi: 10.1016/j.intimp.2023.109895. Epub 2023 Feb 18.

Abstract

As the intensive anti-tumour therapy and combination of multiple anti-tumour drugs, cardiotoxicity events caused by anti-tumour drugs have also increased significantly, and the incidence of cardiotoxicity also increased with survival time. Different types of anti-tumour drugs could cause all kinds of cardiotoxicity which increase the difficulties in treatment and even live threatening. In this review, we concentrated in the targeted anti-tumour drugs such as human epidermal growth factor receptor-2 (HER2) inhibitors, tyrosine kinase inhibitors (TKIs), immune checkpoint inhibitors (ICIs), and proteasome inhibitors (Pls). The molecular mechanism of how these drugs induce cardiotoxicity is introduced which includes several signal pathways. These drugs induced cardiotoxicity involved heart failure, hypertension, atherosis and thrombosis, QT interval prolongation, and myocarditis. Some of the cardiotoxicity could be moderate and reversible but others could have happened severely.The aim of this review is to summarise the targeted anti-tumour drugs induced cardiotoxicity and treatment strategies.

摘要

随着强化抗肿瘤治疗以及多种抗肿瘤药物的联合使用,抗肿瘤药物引起的心脏毒性事件也显著增加,且心脏毒性的发生率也随生存时间而上升。不同类型的抗肿瘤药物可导致各种心脏毒性,这增加了治疗难度,甚至危及生命。在本综述中,我们聚焦于靶向抗肿瘤药物,如人表皮生长因子受体2(HER2)抑制剂、酪氨酸激酶抑制剂(TKIs)、免疫检查点抑制剂(ICIs)和蛋白酶体抑制剂(Pls)。介绍了这些药物诱导心脏毒性的分子机制,其中包括多种信号通路。这些药物诱导的心脏毒性涉及心力衰竭、高血压、动脉粥样硬化和血栓形成、QT间期延长以及心肌炎。有些心脏毒性可能是中度且可逆的,但其他的可能会严重发生。本综述的目的是总结靶向抗肿瘤药物诱导的心脏毒性及治疗策略。

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