在晚期前列腺癌中的心脏瘤学
Kenneth Chen1,2, Ting Hong Wong3, Yu Guang Tan1
1Department of Urology, Singapore General Hospital, Singapore, Singapore.
Frontiers in oncology
|July 1, 2024
概括
先进的前列腺癌治疗方法,如雄激素剥夺疗法 (ADT) 和雄激素受体通路抑制剂 (ARPi),可以提高存活率,但会带来心血管风险. 优化心血管健康对于接受这些治疗的患者至关重要.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 先进的前列腺癌治疗方法,包括雄激素剥夺疗法 (ADT) 和雄激素受体通路抑制剂 (ARPi),改善了患者的生存率.
- ADT和ARPi都与显著的心血管毒性有关,在具有先前存在心血管风险因素的人群中加剧风险.
- 有必要解决和管理前列腺癌幸存者经历激素操纵的心血管健康的关键需求.
研究的目的:
- 审查激素治疗在转移性激素敏感前列腺癌中对心血管的影响.
- 为减轻与ADT和ARPi相关的心血管毒性提出策略.
- 提高人们对当前前列腺癌激素管理对心血管的影响的认识.
主要方法:
- 在前列腺癌中与ADT和ARPi相关的心血管毒性的文献综述.
- 讨论心血管风险评估工具 (例如,SCORE2).
- 探索治疗降级策略和生物标志物 (如AR-V7) 在个性化治疗中的作用.
主要成果:
- 没有针对ADT/ARPi心血管毒性的特定计算器;可以使用SCORE2等一般工具.
- 选择的患者可能受益于减缓ADT,如果他们表现出异常的PSA反应,具有有利的疾病特征和显著的并发症.
- 像AR-V7这样的生物标志物可以识别适合减缓治疗的患者,同时优化可修改的心血管风险因素 (ABCDE框架,运动) 是必不可少的.
结论:
- 在接受激素治疗的晚期前列腺癌患者中,管理心血管健康至关重要.
- 个性化治疗降级和风险因素优化是缓解心血管毒性的关键策略.
- 需要进一步的研究和提高人们对前列腺癌激素治疗对心血管的影响的认识.
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