Cardiovascular Toxicity Related to Cancer Treatment: A Pragmatic Approach to the American and European Cardio-Oncology Guidelines.
Cardiovascular Toxicity Related to Cancer Treatment: A Pragmatic Approach to the American and European Cardio-Oncology Guidelines.
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DOI：
10.1161/jaha.120.018403
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发表时间：
2020-09-15
影响因子：
5.4
通讯作者：
Thuny F
中科院分区：
文献类型：
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作者：
Alexandre J;Cautela J;Ederhy S;Damaj GL;Salem JE;Barlesi F;Farnault L;Charbonnier A;Mirabel M;Champiat S;Cohen-Solal A;Cohen A;Dolladille C;Thuny F
在癌症治疗领域取得的巨大进展导致癌症患者预后的显著改善。然而，这些治疗产生的毒性代表了可能对短期和长期结果有害的成本。影响心血管系统的不良事件是癌症患者整体管理的最大挑战之一，因为它们可能会影响肿瘤最佳治疗的成功。这些不良事件不仅与较老的化疗药物如蒽环类药物有关，而且与许多靶向治疗和免疫治疗有关。认识到这一问题，美国和欧洲的几个肿瘤学和心脏病学管理协会已经发布了关于接受潜在心脏毒性癌症治疗的患者的心血管监测以及心血管毒性管理的指南。然而，支持这些指南的证据水平低，导致了许多差异，使临床医生没有一个共识的策略来应用。来自法国心脏肿瘤工作组的心脏肿瘤专家小组进行了一项雄心勃勃的工作，分析和协调最新的美国和欧洲指南，提出路线图和决策算法，便于临床医生在日常实践中使用。在这份声明中，专家们讨论了与心血管毒性风险最高的癌症药物的心血管监测策略，以及此类毒性的管理。
The considerable progress made in the field of cancer treatment has led to a dramatic improvement in the prognosis of patients with cancer. However, toxicities resulting from these treatments represent a cost that can be harmful to short‐ and long‐term outcomes. Adverse events affecting the cardiovascular system are one of the greatest challenges in the overall management of patients with cancer, as they can compromise the success of the optimal treatment against the tumor. Such adverse events are associated not only with older chemotherapy drugs such as anthracyclines but also with many targeted therapies and immunotherapies. Recognizing this concern, several American and European governing societies in oncology and cardiology have published guidelines on the cardiovascular monitoring of patients receiving potentially cardiotoxic cancer therapies, as well as on the management of cardiovascular toxicities. However, the low level of evidence supporting these guidelines has led to numerous discrepancies, leaving clinicians without a consensus strategy to apply. A cardio‐oncology expert panel from the French Working Group of Cardio‐Oncology has undertaken an ambitious effort to analyze and harmonize the most recent American and European guidelines to propose roadmaps and decision algorithms that would be easy for clinicians to use in their daily practice. In this statement, the experts addressed the cardiovascular monitoring strategies for the cancer drugs associated with the highest risk of cardiovascular toxicities, as well as the management of such toxicities.