Moreno-Arciniegas Andrea, Cádiz Laura, Galán-Arriola Carlos, Clemente-Moragón Agustín, Ibáñez Borja
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
Basic Res Cardiol. 2025 Feb;120(1):71-90. doi: 10.1007/s00395-024-01078-6. Epub 2024 Sep 9.
Thanks to the fantastic progress in cancer therapy options, there is a growing population of cancer survivors. This success has resulted in a need to focus much effort into improving the quality of life of this population. Cancer and cardiovascular disease share many common risk factors and have an interplay between them, with one condition mechanistically affecting the other and vice versa. Furthermore, widely prescribed cancer therapies have known toxic effects in the cardiovascular system. Anthracyclines are the paradigm of efficacious cancer therapy widely prescribed with a strong cardiotoxic potential. While some cancer therapies cardiovascular toxicities are transient, others are irreversible. There is a growing need to develop cardioprotective therapies that, when used in conjunction with cancer therapies, can prevent cardiovascular toxicity and thus improve long-term quality of life in survivors. The field has three main challenges: (i) identification of the ultimate mechanisms leading to cardiotoxicity to (ii) identify specific therapeutic targets, and (iii) more sensible diagnostic tools to early identify these conditions. In this review we will focus on the cardioprotective strategies tested and under investigation. We will focus this article into anthracycline cardiotoxicity since it is still the agent most widely prescribed, the one with higher toxic effects on the heart, and the most widely studied.
得益于癌症治疗方案取得的惊人进展,癌症幸存者的数量日益增加。这一成功使得有必要投入大量精力来改善这一群体的生活质量。癌症和心血管疾病有许多共同的风险因素,且二者相互影响,一种疾病会在机制上影响另一种疾病,反之亦然。此外,广泛应用的癌症治疗方法对心血管系统具有已知的毒性作用。蒽环类药物是广泛应用的有效癌症治疗药物的典型代表,具有很强的心脏毒性潜力。虽然一些癌症治疗方法的心血管毒性是暂时的,但其他一些则是不可逆的。越来越需要开发心脏保护疗法,当与癌症治疗联合使用时,这种疗法可以预防心血管毒性,从而提高幸存者的长期生活质量。该领域面临三个主要挑战:(i)确定导致心脏毒性的最终机制,(ii)确定特定的治疗靶点,以及(iii)更合理的诊断工具以早期识别这些病症。在本综述中,我们将重点关注已测试和正在研究的心脏保护策略。我们将把本文重点放在蒽环类药物的心脏毒性上,因为它仍然是处方最广泛的药物,对心脏毒性作用最大,也是研究最广泛的药物。