低心血管风险的三阴性乳腺癌患者的动态心脏变化,这些患者接受了化疗免疫治疗
Jean Philippe Nesseler1, Katrina D Silos1, Olivia Peony1
1Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Cardio-oncology (London, England)
|July 3, 2025
概括
针对三阴性乳腺癌 (TNBC) 的新辅助化疗-免疫疗法可以导致早期心血管事件,即使在低风险患者中. 在治疗期间仔细监测心脏变化至关重要.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 新辅助化疗-免疫疗法是高风险的早期三阴性乳腺癌 (TNBC) 的标准.
- 与 antracyclines, pembrolizumab 和放射治疗相关的心血管风险需要对早期心脏变化的现实世界评估.
研究的目的:
- 在接受新辅助化疗-免疫治疗的早期TNBC患者中评估早期心血管毒性.
- 在这个患者群体中确定心脏事件发生率和风险因素.
主要方法:
- 在2018年至2023年期间,对85名早期TNBC妇女进行了回顾性分析.
- 在治疗期间/治疗后对胸前心电图 (TTE) 和心电图 (ECG) 的评估与基线.
- 计算心脏事件的累积发病率和细灰色回归.
主要成果:
- 11%的患者经历了≥2级心脏事件,平均发病时间为7.3个月.
- 左前下垂冠状动脉辐射剂量与心脏事件风险增加有关 (SHR 1.16/Gy).
- 在治疗期间/治疗后观察到QTc延长 (≥450毫秒) 和新的中度扩张功能障碍.
结论:
- 在多模式TNBC治疗期间,即使在低风险患者中,也会发生早期心血管毒性.
- 在这个队列中,对心脏事件的勤奋监测很重要.
- 需要进一步研究以了解长期影响和恢复模式.
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