Pedersen Sidsel, Nielsen Marc Østergaard, Donia Marco, Svane Inge Marie, Zerahn Bo, Ellebaek Eva
Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark.
Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark.
Cancers (Basel). 2024 Aug 23;16(17):2945. doi: 10.3390/cancers16172945.
Modern therapies targeting the BRAF gene mutation in advanced melanoma have significantly improved patient outcomes but pose cardiovascular risks. This retrospective study in Eastern Denmark (2019-2022) assessed 108 melanoma patients treated with encorafenib and binimetinib. Patients were monitored for heart function using multigated acquisition (MUGA) scans. The study defined major cardiotoxicity as a decline in left ventricular ejection fraction (LVEF) by more than 10 percentage points to below 50%, and minor cardiotoxicity as a decrease in LVEF by more than 15 points but remaining above 50%. Results showed that 19 patients (18%) developed minor cardiotoxicity and were asymptomatic, while 7 (6%) experienced major cardiotoxicity, with two requiring intervention. Notably, no significant declines in LVEF were observed after six months of treatment. The study concluded that significant cardiotoxicity occurred in 6% of cases, mostly asymptomatic and reversible, and suggests that monitoring LVEF could potentially be reduced after 6-9 months if no early signs of cardiotoxicity are detected. This provides valuable insights into the cardiac safety of these treatments in real-world settings.
针对晚期黑色素瘤中BRAF基因突变的现代疗法显著改善了患者的治疗效果，但也带来了心血管风险。这项在丹麦东部进行的回顾性研究（2019 - 2022年）评估了108例接受恩考芬尼和比美替尼治疗的黑色素瘤患者。使用多门控采集（MUGA）扫描监测患者的心脏功能。该研究将严重心脏毒性定义为左心室射血分数（LVEF）下降超过10个百分点至低于50%，轻度心脏毒性定义为LVEF下降超过15个百分点但仍高于50%。结果显示，19例患者（18%）出现轻度心脏毒性且无症状，7例（6%）出现严重心脏毒性，其中2例需要干预。值得注意的是，治疗6个月后未观察到LVEF有显著下降。该研究得出结论，6%的病例出现了严重心脏毒性，大多无症状且可逆转，并表明如果未检测到心脏毒性的早期迹象，6 - 9个月后可能可以减少对LVEF的监测。这为这些治疗在现实环境中的心脏安全性提供了有价值的见解。
