针对性治疗与IV期肺癌患者的有针对性治疗相关心脏毒性,有或没有心脏并发症
Yanmei Peng1, Dong Li2, Jason A Wampfler3
1Department of Oncology, Fangshan Hospital Beijing University of Chinese Medicine, Beijing 102400, P.R. China.
Oncology reports
|December 20, 2024
概括
心脏并发症在接受向治疗的高级非小细胞肺癌 (NSCLC) 患者中显著增加心脏毒性风险. 尽管如此,心脏毒性可能与改善的生存率有关,除了 osimertinib 用户.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
背景情况:
- 向疗法已经改变了高级非小细胞肺癌 (NSCLC) 治疗.
- 心脏并发症和毒性对接受向治疗的NSCLC患者的影响尚不清楚.
研究的目的:
- 研究针对性治疗治疗的IV期NSCLC患者心脏并发症和心脏毒性的患病率和影响.
- 为了比较不同并发症组的心脏毒性风险和生存结果.
主要方法:
- 一项为期14年的队列研究,对3767名IV期NSCLC患者进行了研究,重点是接受向治疗的701名患者.
- 使用考克斯比例危险模型分析心脏并发症,心脏毒性和存活率.
- 心脏毒性率和死亡风险的比较心脏,其他和没有伴随性疾病的患者.
主要成果:
- 19.0%的向治疗接受者患有心脏病并发症;2.1%患有心脏毒性,仅限于患有并发症的患者 (10心脏病,5其他).
- 与其他并发性疾病相比,心脏并发性疾病的心脏毒性风险是7.5倍以上 (7.5%对1.0%).
- 患有心脏毒性患者的中位生存时间较长 (4.7年),死亡风险较低 (HR 0.45),比没有心脏毒性患者 (1.9年).
- 接受奥西默提尼布治疗的患有心脏并发症的患者面临1.7倍的死亡风险.
- 接受ALK/ROS1抑制剂治疗的患有心脏病的患者心脏毒性率高出14倍 (30.0%对2.1%).
结论:
- 心脏毒性在治疗向药物的IV期NSCLC患者中不常见,但在心脏并发症患者中更为普遍.
- 心脏病并发症似乎是一般向治疗中延长存活时间的保护因素,但在 osimertinib 治疗中增加死亡率.
- 像ALK/ROS1抑制剂这样的特定向疗法在患有先前心脏病的患者中显示出显著更高的心脏毒性.
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