在HER2向治疗期间减少心脏毒性监测的心脏安全性
Anthony F Yu1, Chau T Dang1, Chaya S Moskowitz2
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
JACC. CardioOncology
|June 19, 2025
概括
每6个月减少回声心电图监测对HER2向治疗患者来说是安全的,监测低风险的癌症治疗相关心脏功能障碍 (CTRCD). 这种方法是可行的,可能适合选择患者.
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:
- 在HER2向治疗中,每3个月一次的心声图是癌症治疗相关心脏功能障碍 (CTRCD) 监测的标准.
- 更安全的针对HER2的疗法降低了CTRCD风险,质疑密集监测的必要性.
研究的目的:
- 在非环素HER2向治疗期间,评估减少CTRCD监测 (每6个月一次) 的心脏安全性.
- 评估更少频繁的心声回声图表计划的可行性.
主要方法:
- 一项非随机临床试验包括了190名HER2阳性乳腺癌患者,接受非环素HER2向治疗.
- 每6个月进行一次心声图;排除标准包括先前使用甲环素和心血管疾病.
- 主要结局是1年心脏事件 (心力衰竭,心血管死亡).
主要成果:
- 在190名患者中,在中位数为17.5个月的随访期间,没有发生心脏事件 (0%;97.5%CI:0%-1.9%).
- 一名患者 (0.5%) 发展了无症状的CTRCD,在中断后恢复治疗.
- 遵守6个月监测计划的比例为73.2% (治疗意向).
结论:
- 减少每6个月一次的CTRCD监测对于低风险患者来说是安全的和可行的.
- 这种策略可能适用于不涉及 antracyclines 的 HER2 向治疗方案.
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