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类他类药物用于人类循环素心脏毒性的初级预防:综合性审查
Varun Bhasin1, Azin Vakilpour1, Marielle Scherrer-Crosbie2
1Division of Cardiovascular Medicine and Thalheimer Center for Cardio-Oncology, Perelman Center for Advanced Medicine and Hospital of the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, USA.
类药物可能有助于预防化学疗法药物 - - 称为人环素 - - 引起的心脏损伤. 虽然观察性研究表明有好处,但临床试验有混合的结果,需要更多的研究来获得明确的答案.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 人环素是具有已知的心脏毒性的强效化疗剂.
- 炭环素的心脏毒性可能会导致癌症患者的严重心脏并发症.
- 类药物是降脂药物,具有潜在的抗炎和心脏保护性质.
研究的目的:
- 审查他类药物可能提供对抗环素诱导心脏毒性的保护机制.
- 综合评估关于他类药物的临床证据,以预防因人环素引起的心脏毒性.
主要方法:
- 临床前和临床研究的文献综述.
- 对观察数据和随机对照试验 (RCT) 的分析.
- 检查拟议的分子机制,包括Rho GTPase抑制.
主要成果:
- 观察性研究表明,他类药物可以降低因 antracycline 引起的心脏毒性的风险.
- 拟议的机制包括抑制Ras同类 (Rho) GTPases.
- 最近的RCT就他类药物的疗效产生了相互矛盾的结果.
- 在接受 antracyclines 的患者中,他类药物与心脏功能障碍的发病率降低有关.
结论:
- 需要进一步阐明他类药物对人环素的精确心脏保护机制.
- 目前来自RCT的证据是不确定的,需要更大规模的试验和更长的随访.
- 确定从他类药物治疗中获益最多的特定患者亚组至关重要.
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