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三阴性乳腺癌的治疗进展及随之而来的心脏毒性。

Evolving therapeutics and ensuing cardiotoxicities in triple-negative breast cancer.

机构信息

Department of Medicine, Xinglin College, Nantong University, Nantong 226007, Jiangsu, China.

The First Clinical Medical College, Nanjing Medical University, Nanjing 211166, Jiangsu, China; Sir Run Run Hospital, Nanjing Medical University, Nanjing 211112, Jiangsu, China.

出版信息

Cancer Treat Rev. 2024 Nov;130:102819. doi: 10.1016/j.ctrv.2024.102819. Epub 2024 Aug 30.

Abstract

Defined as scarce expression of hormone receptors and human epidermal growth factor receptor 2, triple-negative breast cancer (TNBC) is labeled as the most heterogeneous subtype of breast cancer with poorest prognosis. Despite rapid advancements in precise subtyping and tailored therapeutics, the ensuing cancer therapy-related cardiovascular toxicity (CTR-CVT) could exert detrimental impacts to TNBC survivors. Nowadays, this interdisciplinary issue is incrementally concerned by cardiologists, oncologists and other pertinent experts, propelling cardio-oncology as a booming field focusing on the whole-course management of cancer patients with potential cardiovascular threats. Here in this review, we initially profile the evolving molecular subtyping and therapeutic landscape of TNBC. Further, we introduce various monitoring approaches of CTR-CVT. In the main body, we elaborate on typical cardiotoxicities ensuing anti-TNBC treatments in detail, ranging from chemotherapy (especially anthracyclines), surgery, anesthetics, radiotherapy to immunotherapy, with future perspectives on promising directions in the era of artificial intelligence and traditional Chinese medicine.

摘要

三阴性乳腺癌(TNBC)被定义为激素受体和人表皮生长因子受体 2 表达稀少,是乳腺癌中预后最差的最具异质性亚型。尽管在精确分型和靶向治疗方面取得了快速进展,但随之而来的癌症治疗相关心血管毒性(CTR-CVT)可能对 TNBC 幸存者产生不利影响。如今,心脏病学家、肿瘤学家和其他相关专家越来越关注这个跨学科问题,推动了肿瘤心脏病学的发展,该学科专注于对有潜在心血管威胁的癌症患者进行全程管理。在这篇综述中,我们首先描述了 TNBC 不断发展的分子分型和治疗领域。此外,我们还介绍了 CTR-CVT 的各种监测方法。在正文部分,我们详细阐述了抗 TNBC 治疗后出现的典型心脏毒性,包括化疗(尤其是蒽环类药物)、手术、麻醉、放疗和免疫治疗,并对人工智能和中医药时代有前景的方向进行了展望。

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