酪氨酸激酶抑制剂抗肿瘤治疗相关心脏毒性研究进展

与传统化疗相比，靶向治疗可抑制与肿瘤发生和转移相关信号通路中的关键分子，从而成为一种新的抗肿瘤治疗策略。酪氨酸激酶抑制剂（TKI）是目前治疗肾细胞癌、胃肠道间质瘤和胰腺癌等的多靶点抗肿瘤药物，可靶向抑制癌基因相关受体酪氨酸激酶（RTK）。值得注意的是，排除恶性肿瘤本身导致的死亡，治疗引起的相关不良心血管事件亦成为肿瘤患者死亡的主要原因。重点介绍几种小分子酪氨酸激酶抑制剂（舒尼替尼、索拉菲尼、帕唑帕尼和阿西替尼）相关的心脏毒性的发生率，包括左心室功能不全、缺血性心肌病、高血压和血栓栓塞事件，并探讨这几种药物导致心脏毒性的可能分子机制。

Cardio-oncology: a focused review of anthracycline-, human epidermal growth factor receptor 2 inhibitor-, and radiation-induced cardiotoxicity and management

Compared with traditional chemotherapy, targeted cancer therapy is a novel strategy that inhibits the key molecules in signalling pathways involved in carcinogenesis and tumor metastasis. Tyrosine kinase inhibitors (TKIs) are multi-targeted anti-cancer agents for the treatment of renal cell carcinoma, gastrointestinal stromal tumor and pancreatic cancer, and can exert targeted inhibition on oncogene-associated receptor tyrosine kinase (RTK). Interestingly, besides death related to the malignancy itself, chemotherapy-related adverse cardiovascular events are the leading cause of death in cancer patients. In this review, we focused on several small-molecule TKIs(sunitinib, sorafenib, pazopanib, axitinib) and the incidence of cardiotoxicities associated with their use, including left ventricular dysfunction, ischemic cardiomyopathy, hypertension and thromboembolic events, and summarized the potential molecular mechanisms of their adverse cardiovascular effects.