抗人表皮生长因子受体2单克隆抗体在乳腺癌治疗中的心脏毒性

Cardiotoxicity of anti-human epidermal growth factor receptor 2 monoclonal antibody in breast cancer treatment

靶向治疗具有高特异性和低毒性, 是人表皮生长因子受体2(HER2)阳性乳腺癌重要治疗手段, 能延长HER2阳性早期乳腺癌患者的无病生存时间和总生存时间, 明显延长HER2阳性晚期乳腺癌患者的无进展生存时间和总生存时间。但靶向药物也可阻断靶器官外正常信号通路, 部分患者出现治疗相关不良反应, 导致剂量降低、治疗延迟和中断, 甚至危及患者生命。不良反应中心脏毒性是靶向HER2药物潜在的严重不良反应之一。目前应用于HER2阳性乳腺癌临床治疗的靶向药物有大分子单克隆抗体类药物(如曲妥珠单抗、帕妥珠单抗)、抗体-药物偶联物(如T-DM1、T-DXd)以及小分子酪氨酸激酶抑制剂等。文章就包括抗体-药物偶联物的单克隆抗体类药物的HER2靶向药物在乳腺癌靶向治疗中的心脏毒性进行综述, 为临床用药提供参考。

Targeted therapy characterized with high specificity and low toxicity,is an important treatment method for human epidermal growth factor receptor 2(HER2)-positive breast cancer,which can prolong the disease-free survival and the overall survival time of HER2-positive early breast cancer patients,and prolong the progression-free survival and the overall survival time of HER2-positive advanced patients with breast cancer.However,targeted drugs blocked the normal signaling pathway outside the target organs,and some patients experienced treatment-related adverse reactions,resulting in dose reduction,treatment delay and interruption,or even life-threatening consequences.Cardiotoxicity is one of the potentially serious side effects of targeted-HER2 drugs.Currently the targeted drugs for treatment of HER2-positive breast cancer patients include macromolecular monoclonal antibody drugs such as trastuzumab and pertuzumab,antibody-drug conjugates such as T-DM1 and T-DXd,and small-molecule tyrosine kinase inhibitors.This paper reviews the cardiotoxicity of HER2 targeted drugs including antibody-drug conjugates monoclonal antibody drugs in targeted therapy for breast cancer in order to provide references for clinical treatment.