Stanford Cardiovascular Institute, Stanford, CA, 94305, USA.
Baszucki Family Vascular Surgery Biobank, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Curr Cardiol Rep. 2024 Sep;26(9):953-971. doi: 10.1007/s11886-024-02099-2. Epub 2024 Jul 23.
This review explores the cardiovascular toxicity associated with cancer therapies, emphasizing the significance of the growing field of cardio-oncology. It aims to elucidate the mechanisms of cardiotoxicity due to radiotherapy, chemotherapy, and targeted therapies, and to discuss the advancements in human induced pluripotent stem cell technology (hiPSC) for predictive disease modeling.
Recent studies have identified several chemotherapeutic agents, including anthracyclines and kinase inhibitors, that significantly increase cardiovascular risks. Advances in hiPSC technology have enabled the differentiation of these cells into cardiovascular lineages, facilitating more accurate modeling of drug-induced cardiotoxicity. Moreover, integrating hiPSCs into clinical trials holds promise for personalized cardiotoxicity assessments, potentially enhancing patient-specific therapeutic strategies. Cardio-oncology bridges oncology and cardiology to mitigate the cardiovascular side-effects of cancer treatments. Despite advancements in predictive models using hiPSCs, challenges persist in accurately replicating adult heart tissue and ensuring reproducibility. Ongoing research is essential for developing personalized therapies that balance effective cancer treatment with minimal cardiovascular harm.
本综述探讨了癌症治疗相关的心血管毒性，强调了日益发展的肿瘤心脏病学领域的重要性。旨在阐明放疗、化疗和靶向治疗引起的心脏毒性的机制，并讨论人诱导多能干细胞（hiPSC）技术在预测性疾病建模方面的进展。
最近的研究已经确定了几种化疗药物，包括蒽环类药物和激酶抑制剂，它们显著增加了心血管风险。hiPSC 技术的进步使这些细胞分化为心血管谱系，更准确地模拟药物引起的心脏毒性。此外，将 hiPSC 整合到临床试验中有望进行个性化的心脏毒性评估，从而增强针对特定患者的治疗策略。肿瘤心脏病学将肿瘤学和心脏病学结合起来，以减轻癌症治疗的心血管副作用。尽管使用 hiPSC 进行预测模型取得了进展，但在准确复制成人心脏组织和确保可重复性方面仍然存在挑战。正在进行的研究对于开发平衡有效癌症治疗和最小化心血管损伤的个性化治疗方法至关重要。
