与抗癌药物相关的心脏毒性来自辅助性戈塞林和他莫西芬治疗
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Updated: May 31, 2025

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Olivia Manfrini1,2, Edina Cenko1, Maria Bergami1
1Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Journal of clinical medicine
|January 25, 2025
概括
用戈塞林和他莫西芬辅助内分泌治疗在一年以上的绝经前乳腺癌患者中没有显著影响左心室 (LV) 功能. 这种组合疗法在抗癌药物相关心脏毒性 (ADRC) 方面似乎是安全的.
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:
- 全球乳腺癌发病率正在上升,内分泌疗法改善了绝经前妇女的结果.
- 内分泌治疗可以诱导更年期,可能增加心血管风险,如左心室 (LV) 功能障碍.
- 这项研究调查了在更年期前的乳腺癌患者中戈塞林和他莫西芬对心血管的影响.
研究的目的:
- 评估一年的辅助性戈塞林和他莫西芬对绝经前乳腺癌患者的LV功能的影响.
- 评估与这种内分泌疗法相关的抗癌药物相关心脏毒性 (ADRC) 的发生率.
- 为了确定瑟林和他莫西芬联合治疗是否会影响左心室喷射率 (LVEF).
主要方法:
- 使用ISACS心血管毒性注册表 (NCT01218776),这是一个试点多中心注册表.
- 采用治疗权重的逆概率 (IPTW) 分析,对70名接受戈塞林和他莫西芬联合治疗的患者和120名对照患者进行了分析.
- 评估的主要结局:低LV功能 (LVEF<65%) 和亚临床LV功能障碍 (LVEF下降10个百分点) 在1年的随访.
主要成果:
- 与对照组相比,联合戈塞林和他莫西芬治疗在3,6或12个月后没有显著改变平均LV功能.
- 在12个月后,组合治疗组和对照组之间,LVEF的平均减少是相似的.
- 根据IPTW的分析,联合治疗与低LV功能或亚临床LV功能障碍之间没有显著的关联.
结论:
- 在侵袭性乳腺癌患者中,一年的辅助戈塞林和他莫西芬治疗似乎不会引起与抗癌药物相关的心脏毒性 (ADRC).
- 这些发现表明,这种内分泌疗法对LV功能来说是安全的,无论疾病的严重程度如何.
- 需要进行更大规模的研究才能最终证实这些结果.
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