癌症治疗与心脏毒性事件相关,这些事件易导致心脏病变并损害患者的生存率。有必要鉴定新的分子生物标志物来检测心脏毒性。本范围审查旨在确定在接受癌症治疗的成年人群中与心脏毒性相关的新型分子生物标志物的可用证据。
Medline数据库,WebofScience,Scopus,和Embase在2020年8月23日之前进行了筛选,以鉴定已发表的研究,寻找成年患者癌症治疗相关心功能障碍中报告的新型分子生物标志物。共纳入42项符合资格标准的研究。14项研究报告了44种新的蛋白质生物标志物,18项研究报告了57种新的单核苷酸多态性生物标志物,11项研究报告了171个与心脏毒性相关的新基因表达谱。在7084名癌症患者中报告和评估了272种新型分子生物标志物的数据。其中只有13项是在一项以上的研究中确定的(MPO,sST2,GDF-15,TGF-B1,rs1056892,rs1883112,rs4673,rs13058338,rs1695,miR-1,miR-25-3p,miR-34a-5p,和miR-423-5p),显示曲线下面积值>0.73(范围0.74-0.85),比值比0.26-7.17,危险比1.28-1.80。
多项研究提出了大量新的分子生物标志物作为癌症治疗相关心功能不全风险评估的有前景的预测因子。但是所进行的研究的特征和应用的测定结果不允许建议将这些分子生物标志物用于评估癌症治疗引起的心脏毒性。
Cancer treatments are associated with cardiotoxic events that predispose to cardiac pathology and compromise the survival of patients, making necessary the identification of new molecular biomarkers to detect cardiotoxicity. This scoping
review aims to identify the available evidence on novel molecular biomarkers associated with cardiotoxicity in the adult population undergoing cancer therapy.
The databases Medline, Web of Science, Scopus, and Embase were screened for the identification of published studies until 23 August 2020, searching for novel molecular biomarkers reported in cancer therapy-related cardiac dysfunction in adult patients. A total of 42 studies that met the eligibility criteria were included. Fourteen studies reported 44 new protein biomarkers, 18 studies reported 57 new single nucleotide polymorphism biomarkers, and 11 studies reported 171 new gene expression profiles associated with cardiotoxicity. Data were extracted for 272 novel molecular biomarkers reported and evaluated in 7084 cancer patients, of which only 13 were identified in more than one study (MPO, sST2, GDF-15, TGF-B1, rs1056892, rs1883112, rs4673, rs13058338, rs1695, miR-1, miR-25-3p, miR-34a-5p, and miR-423-5p), showing values for area under the curve > 0.73 (range 0.74-0.85), odds ratio 0.26-7.17, and hazard ratio 1.28-1.80.
Multiple studies presented a significant number of novel molecular biomarkers as promising predictors for risk assessment of cardiac dysfunction related to cancer therapy, but the characteristics of the studies carried out and the determinations applied do not allow suggesting the clinical use of these molecular biomarkers in the assessment of cancer therapy-induced cardiotoxicity.