早期乳腺癌携带生殖系BRCA1/2突变的患者中,人环素诱导的心脏毒性:BRCAN研究
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Alfonso Cortés-Salgado1, Juan José Serrano2, David Cordero Pereda3
1Medical Oncology Department, Hospital Universitario Ramón y Cajal (IRYCIS), 28034 Madrid, Spain.
The oncologist
|November 19, 2024
概括
与非携带者相比,患有生殖系BRCA1/2突变 (gBRCA1/2m) 的患者在接受 antracycline 化疗后,左心室射出分数 (LVEF) 的减少更大. 这表明gBRCA1/2m患者在癌症治疗期间可能需要更密切的心脏监测.
科学领域:
- 心脏瘤学 - 心脏瘤学
- 遗传学 遗传学 是一个
- 在瘤学瘤学.
背景情况:
- BRCA1/2基因对DNA修复和基因组稳定性至关重要.
- 在动物模型中,心肌细胞BRCA1 / 2的损失导致心脏损伤和死因.
- 人类与BRCA1/2在人环素诱导心脏毒性 (AIC) 中的作用的相关性尚未得到充分证实.
研究的目的:
- 为了研究生殖线BRCA1/2 (gBRCA1/2) 状态对环素诱导心脏毒性 (AIC) 的影响.
- 为了比较早期乳腺癌患者的左心室喷射分数 (LVEF) 变化,有或没有gBRCA1/2突变的患者接受了 antracycline 化疗.
- 评估群体之间的心肌功能障碍血液生物标志物 (MDBB) 和生活质量 (QoL) 的差异.
主要方法:
- 早期乳腺癌患者的回顾性/前性队列研究.
- 排除先前接受过抗HER2治疗,先前患有心血管疾病或基线LVEF异常的患者.
- 通过心声学,MDBB和QoL问卷评估LVEF,将gBRCA1/2突变载体 (gBRCA1/2m) 与非载体 (gBRCA1/2wt) 进行比较.
主要成果:
- 包括137名患者:34个gBRCA1/2m和103个gBRCA1/2wt.
- 在gBRCA1/2m患者 (-9.5%) 与gBRCA1/2wt患者 (-4.7%) (P=0.027) 相比,观察到LVEF的统计学上显著较大降低.
- 调整后的分析证实了LVEF降低的显著差异 (-4.5%,P=0.032);没有发现MDBB或QoL的显著差异.
结论:
- 生殖系BRCA1/2突变携带者代表了患有AIC的风险较高的人群.
- 在确定辅助性 antracyclines 的必要性时,应考虑 gBRCA1/2 状态.
- 这一患者群可能会从加强心脏瘤监测和心脏保护干预中受益.
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