针对HER2的治疗和心脏毒性:从主要问题到可管理的风险
Rio Putra Pamungkas1, Laras Pratiwi1, Henry Sutanto1
1Internal Medicine Study Program, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, INDONESIA; Department of Internal Medicine, Dr. Soetomo General Academic Hospital, Surabaya, INDONESIA.
Current problems in cardiology
|September 5, 2025
概括
针对HER2的治疗改善了乳腺癌的结果,但可能导致心脏毒性. 然而,大多数心脏事件是轻微的和可逆的监测,允许安全继续HER2治疗.
科学领域:
- 心脏瘤学
- 医疗瘤学
- 心血管医学
背景情况:
- 针对HER2的疗法彻底改变了HER2阳性乳腺癌的治疗方法.
- 心脏毒性是一个重大问题,历史上与人环素和HER2抑制剂有关.
- 由于早期对心脏毒性的担忧,因此制定了密集的心脏监测.
研究的目的:
- 批判性地研究HER2治疗引起的心脏毒性.
- 审查心脏毒性临床风险因素和管理策略.
- 论证HER2治疗的安全延续与监测和多学科护理.
主要方法:
- 对早期试验数据和HER2治疗心脏毒性的新证据的审查.
- 对心脏功能障碍的临床决定因素和潜在生物标志物的分析.
- 检查HER2抑制对心肌细胞功能的机制性途径.
- 包括SAFE-HEaRt等关于安全延续治疗的研究结果.
主要成果:
- 大多数心脏毒性事件无症状,可逆,很少需要停止治疗.
- 临床决定因素包括基线心脏功能,年龄,并发症和化疗组合.
- 生物标志物和先进的成像显示了早期发现心脏问题的前景.
- 在心脏瘤监督和心脏保护下,通常可以安全地进行HER2治疗.
结论:
- 针对HER2治疗的心脏毒性通常是可以控制和可逆的.
- 风险分层,监测和综合护理对于最佳结果至关重要.
- 在适当的监测和多学科管理下,心脏毒性不必阻碍有效的针对HER2的癌症治疗.
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