肿瘤心脏病学研究进展与临床药师的价值

Research Progress in the Discipline of Onco-Cardiology and the Value of Clinical Pharmacists

肿瘤心脏病学作为整合恶性肿瘤与心血管疾病两个领域的新兴交叉学科,在我国的发展方兴未艾。目前,抗肿瘤药所致心血管不良反应仍是该学科的研究重点,尤以蒽环类等化疗药、人表皮生长因子受体2抑制剂等靶向治疗药物和免疫检查点抑制剂等免疫治疗药物引发的心血管毒性为代表。对抗肿瘤药心血管毒性的一级预防和早期治疗是改善肿瘤患者预后的重要手段。随着肿瘤心脏病学学科的进展,基础研究逐渐通过转化医学的形式落实到临床实践,患者的获益不仅局限于抗肿瘤治疗心血管毒性的缓解与改善,还包括肿瘤患者基础心血管疾病治疗计划的优化与调整。临床药师在肿瘤心脏病学多学科诊疗团队中,可以通过减少用药错误、警示药物相互作用、提供药物基因组学信息、治疗药物管理等形式,协助临床团队制定和调整患者的诊疗计划,实现个体化和精准化诊疗,减毒增效。

Onco-cardiology is an emerging interdiscipline that integrates the fields of malignant tumors and cardiovascular diseases,and its development in China is in the ascendant.At present,cardiovascular adverse reactions caused by antineoplastic drugs are still the research focus in this discipline,especially cardiovascular toxicity caused by chemotherapeutic drugs such as anthracyclines,targeted therapeutic drugs such as human epidermal growth factor receptor 2 inhibitors and immunotherapy drugs such as immune checkpoint inhibitors.Primary prevention and early treatment for cardiovascular toxicity of antineoplastic drugs are important measures to improve the prognosis of patients with onco-cardiological disease.With the progress of discipline of onco-cardiology,basic research is gradually implemented into clinical practice in the form of translational medicine,patients benefit not only limited to the remission and improvement of cardiovascular toxicity from antineoplastic therapy,but also the optimization and adjustment of treatment plan for basic cardiovascular disease in tumor patients.In the onco-cardiological multidisciplinary treatment teams,clinical pharmacists can assist clinical teams in formulating and adjusting patients’treatment plans by reducing medication errors,warning drug interactions,providing pharmacogenomic information and therapeutic drug management,so as to carry out individualized and precise treatment,reduce toxicity and increase effectiveness.