Quagliariello Vincenzo, Berretta Massimiliano, Bisceglia Irma, Giacobbe Ilaria, Iovine Martina, Barbato Matteo, Maurea Carlo, Canale Maria Laura, Paccone Andrea, Inno Alessandro, Scherillo Marino, Oliva Stefano, Cadeddu Dessalvi Christian, Mauriello Alfredo, Fonderico Celeste, Maratea Anna Chiara, Gabrielli Domenico, Maurea Nicola
Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy.
Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
Cancers (Basel). 2025 Mar 30;17(7):1169. doi: 10.3390/cancers17071169.
Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay between cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders, significantly impacting cancer patients. The presence of CKM syndrome in cancer patients not only worsens their prognosis but also increases the risk of major adverse cardiovascular events (MACE), reduces quality of life (QoL), and affects overall survival (OS). Furthermore, several anticancer therapies, including anthracyclines, tyrosine kinase inhibitors, immune checkpoint inhibitors, and hormonal treatments, can exacerbate CKM syndrome by inducing cardiotoxicity, nephrotoxicity, and metabolic dysregulation. This review explores the pathophysiology of CKM syndrome in cancer patients and highlights emerging therapeutic strategies to mitigate its impact. We discuss the role of novel pharmacological interventions, including sodium-glucose cotransporter-2 inhibitors (SGLT2i), proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), and soluble guanylate cyclase (sGC) activators, as well as dietary and lifestyle interventions. Optimizing the management of CKM syndrome in cancer patients is crucial to improving OS, enhancing QoL, and reducing MACE. By integrating cardiometabolic therapies into oncologic care, we can create a more comprehensive treatment approach that reduces the burden of cardiovascular and renal complications in this vulnerable population. Further research is needed to establish personalized strategies for CKM syndrome prevention and treatment in cancer patients.
心血管-肾脏-代谢（CKM）综合征代表了心血管疾病（CVD）、慢性肾脏病（CKD）和代谢紊乱之间的复杂相互作用，对癌症患者有重大影响。癌症患者中CKM综合征的存在不仅会恶化其预后，还会增加主要不良心血管事件（MACE）的风险，降低生活质量（QoL），并影响总生存期（OS）。此外，包括蒽环类药物、酪氨酸激酶抑制剂、免疫检查点抑制剂和激素治疗在内的几种抗癌疗法，可通过诱导心脏毒性、肾毒性和代谢失调而加重CKM综合征。本综述探讨了癌症患者中CKM综合征的病理生理学，并强调了减轻其影响的新兴治疗策略。我们讨论了新型药物干预措施的作用，包括钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）、前蛋白转化酶枯草溶菌素/kexin 9型抑制剂（PCSK9i）和可溶性鸟苷酸环化酶（sGC）激活剂，以及饮食和生活方式干预。优化癌症患者CKM综合征的管理对于改善总生存期、提高生活质量和减少MACE至关重要。通过将心脏代谢疗法纳入肿瘤治疗，我们可以创建一种更全面的治疗方法，减轻这一脆弱人群的心血管和肾脏并发症负担。需要进一步研究以制定癌症患者CKM综合征预防和治疗的个性化策略。
