新型抗肿瘤药物致心脏毒性分析

Analysis on new anti-tumor drugs induced cardiotoxicity

目的分析汇总我国上市的新型抗肿瘤药物导致心脏毒性的类型及发生率,为临床安全用药提供依据。方法检索国家药品监督管理局(NMPA)官网,整理可能导致心脏毒性的新型抗肿瘤药物并查阅说明书,整理作用靶点、心脏毒性类型和发生率;检索PubMed、中国知网、万方及维普数据库,查阅关于心脏毒性类型的报道。检索时间均为2000年1月1日至2020年6月30日。结果新型抗肿瘤药物自2000年在我国上市,现有45种可能导致心脏毒性的药物,包括靶向制剂39种和免疫检查点抑制剂6种;覆盖9种常见的肿瘤类型;文献检索结果显示35种新型抗肿瘤药物可以不同程度导致心脏毒性,类型方面占说明书中描述内容的75%,另有6种药物出现说明书中描述以外新的损伤类型。结论新型抗肿瘤药物导致心脏毒性临床表现不一,使用前应建立基线、加强用药管理和监测,保障肿瘤患者治疗顺利完成。

Objective To analyze the types and incidence of cardiotoxicity caused by new anti-tumor post-market drugs in China,and provide basis for drug safety use in practice.Methods This paper sorted out the new anti-tumor drugs on the market in China by searching the National Medical Products Administration(NMPA)website and consulting instructions,list⁃ed the mechanism of action drugs,and the types and incidence of cardiotoxicity;the PubMed,China knowledge net data⁃base,Wangfang database,and VIP database was searched for summarizing cardiac injury cases,from January 1,2000 to June 30,2020.Results All of 45 kinds of new anti-tumor drugs have been approved in China since 2000,including 39 targeted agents and 6 immunosuppressive agents drugs,covering 9 kinds of common malignant tumors.Literature search results showed that 35 kinds of new anti-tumor drugs could cause cardiotoxicity in different degrees,the type of injury accounted for 75%of the description in the instruction manual,and there were 6 new injury types beyond the description in the instruction manual.Conclusion The clinical manifestations of cardiotoxicity are different.For going through the treatment in cancer pa⁃tients,a baseline should be established before use,as well as medication management and monitoring.