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治疗乳腺癌的患者心脏保护:从2 × 2随机,安慰剂控制,双盲SAFE试验的最终分析
I Meattini1, C Becherini2, F Martella3
1Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy; Radiation Oncology and Breast Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
ESMO open
|May 22, 2025
概括
拉米普利和双醇显著减少乳腺癌患者接受 antracycline 化疗的亚临床心脏损伤. 这些发现支持它们作为预防心脏损伤的早期心脏保护策略的使用.
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:
- 作为标准的乳腺癌治疗方法,人环素化疗可以引起心脏毒性和亚临床心脏损伤.
- 对接受化疗的患者来说,早期发现和预防心脏功能障碍至关重要.
研究的目的:
- 评估Ramipril和Bisoprolol在接受基于Anthracycline的化疗的非转移性乳腺癌患者中预防亚临床心脏功能障碍的疗效.
主要方法:
- 该SAFE试验是一项多中心,2x2因子,随机,安慰剂控制,双盲研究,对262名患者进行.
- 患者接受了安慰剂,拉米普利尔,双醇或两者与化疗同时进行.
- 亚临床心脏损伤在24个月后通过心声回声学进行评估,测量了3D-LVEF或GLS的≥10%降低.
主要成果:
- 与安慰剂相比,拉米普利和双醇显著降低了3D左心室喷射率 (3D-LVEF) 和全球纵向应变 (GLS) 的下降 (P < 0.001).
- 在接受拉米普利尔 (11.4%) 或比索普罗罗罗尔 (9.6%) 与安慰剂 (分别为39.3%和43.5%;P <0.001) 的患者中,亚临床心脏损伤发生率显着较低.
结论:
- 拉米普利和双醇有效地降低了乳腺癌患者的亚临床心脏损伤,这些患者接受了环素治疗.
- 这些药物代表了有希望的早期心脏保护策略,用于化疗引起的心脏毒性.
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