PDF(Pubmed)
Abstract：
Cardiotoxicity is a relatively frequent and potentially serious side effect of traditional and targeted cancer therapies. Both general measures and specific pharmacologic cardioprotective interventions as well as imaging- and biomarker-based surveillance strategies to identify patients at high risk have been tested in randomized controlled trials to prevent or attenuate cancer therapy-related cardiotoxic effects. Although meta-analyses including early trials suggest an overall beneficial effect, there is substantial heterogeneity in results. Recent randomized controlled trials of neurohormonal inhibitors in patients receiving anthracyclines and/or human epidermal growth factor receptor 2-targeted therapies have shown a lower rate of cancer therapy-related cardiac dysfunction than previously reported and a modest or no sustained effect of the interventions. Data on preventive cardioprotective strategies for novel cancer drugs are lacking. Larger, prospective multicenter randomized clinical trials testing traditional and novel interventions are required to more accurately define the benefit of different cardioprotective strategies and to refine risk prediction and identify patients who are likely to benefit.
摘要：
心脏毒性是传统和靶向癌症疗法的相对频繁且潜在严重的副作用。已在随机对照试验中测试了一般措施和特定的药物心脏保护干预措施以及基于成像和生物标志物的监测策略以识别高风险患者，以预防或减轻癌症治疗相关的心脏毒性作用。尽管包括早期试验在内的荟萃分析显示了总体有益的效果，结果存在很大的异质性。最近在接受蒽环类和/或人类表皮生长因子受体2靶向治疗的患者中神经激素抑制剂的随机对照试验显示，与癌症治疗相关的心功能不全的发生率低于先前报道的，并且干预措施的效果适中或没有持续的效果。缺乏有关新型癌症药物的预防性心脏保护策略的数据。较大,需要对传统和新型干预措施进行前瞻性多中心随机临床试验,以更准确地定义不同心脏保护策略的益处,并改进风险预测和确定可能受益的患者.
