晚期疾病状态的前列腺癌治疗心脏毒性地图 (PROXMAP):系统性审查和网络元分析与治疗史的贝叶斯模型
Moez Karim Aziz1, Donald Molony2, Dominique Monlezun3
1Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Internal Medicine, Baylor College of Medicine, Houston, TX, USA.
European urology
|September 19, 2024
概括
与包括阿比拉在内的疗法相比,抗雄激素剥夺疗法加上多塞塔克塞尔和达洛胺对转移性激素敏感前列腺癌的心脏毒性较低. 奥拉帕里布还可以降低转移性割抗性前列腺癌的高血压.
科学领域:
- 心脏瘤学 - 心脏瘤学
- 泌尿外科瘤学 泌尿外科瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 目前前前列腺癌治疗指南缺乏心脏毒性数据.
- 评估心脏毒性对于转移性激素敏感 (mHSPC),非转移性割抗性 (M0CRPC) 和转移性割抗性 (mCRPC) 前列腺癌疗法至关重要.
研究的目的:
- 评估mHSPC,M0CRPC和mCRPC的第一线疗法的心脏毒性.
- 使用国际心脏瘤学会指标来比较心脏毒性概况.
主要方法:
- 在Ovid Medline,Embase和Cochrane Library对RCT进行系统的文献搜索.
- 网络元分析构建了五种心脏毒性指标:心力衰竭,心肌炎,血管毒性,高血压和心律失常.
- 贝叶斯网络的元分析包括先前的治疗史.
主要成果:
- 对于mHSPC,与ADT+DTX+AA+P相比,ADT+DTX+DAR显示高血压和心律失常的风险较低.
- 对于mCRPC,当添加到ADT+AA+P时,olaparib (OLA) 显著降低了高血压.
- 对于M0CRPC疗法没有显著的心脏毒性发现.
结论:
- 与ADT+DTX+AA+P相比,ADT+DTX+DAR是mHSPC在心脏毒性方面潜在的更安全的选择.
- 在之前接受过mHSPC治疗的mCRPC患者中,olaparib可能提供心脏毒性益处 (降低高血压).
- 对心脏毒性的进一步研究是必要的,以获得最佳的前列腺癌治疗选择.
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