Zusammenfassung
Hintergrund
Onkologische Therapien zeigen am Herz-Kreislauf-System eine Reihe unerwünschter Wirkungen. Insbesondere neuere Therapien sind diesbezüglich unzureichend verstanden, und klinische Daten fehlen bei der Interpretation neuer kardialer Komplikationen.
Ziel der Arbeit
Der vorliegende Beitrag bietet einen Überblick über die Mechanismen kardialer Nebenwirkungen bestimmter onkologischer Therapien.
Material und Methoden
Die Übersichtsarbeit bezieht sich im Wesentlichen auf Daten präklinischer Untersuchungen.
Ergebnisse
Zahlreiche toxische Nebenwirkungen wurde bereits in präklinischen Modellen vorbeschrieben. Für bestimmte Gruppen von Medikamenten (z. B. Anthrazykline, Tyrosinkinaseinhibitoren, Immun-Checkpoint-Inhibitoren) sind die zugrunde liegenden molekularen Mechanismen aber nicht abschließend geklärt.
Schlussfolgerung
Basierend auf den bekannten molekularen Mechanismen von Kardiotoxizität erschließen sich möglicherweise verbesserte klinische Entscheidungswege. Ein besseres Verständnis ermöglicht auch neue Einblicke in die Pathophysiologie kardialer Erkrankungen. Ziel wird sein, die Ergebnisse translational zu nutzen und in geeigneten kardioonkologischen Einheiten klinisch umzusetzen.
Abstract
Background
Oncological therapies show a number of undesired adverse effects on the cardiovascular system. In particular, the side effects of recently established oncological therapies are incompletely understood and clinical data are lacking in the interpretation of novel cardiac complications.
Objective
This article provides a short overview of the mechanisms of cardiac side effects of certain oncological therapies.
Material and methods
The review is mainly based on data from preclinical studies.
Results
Numerous toxic side effects have already been described and investigated in preclinical models. For certain groups of drugs (e.g. anthracyclines, tyrosine kinase inhibitors and immune checkpoint inhibitors) the underlying molecular mechanisms are still not fully understood.
Conclusion
An improved understanding of the molecular mechanism involved in cardiotoxicity might help improve the quality of clinical decisions. Additionally, it will provide new insights into the pathophysiology of cardiac diseases. The aim is to use the results of translational research and to clinically implement them in suitable cardio-oncology units.
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L.H. Lehmann berät Daiichi Sankyio, Senaca und Servier und erhielt Vortragshonorare von Novartis, Daiichi Sankyio und MSD. S. Fröhling berät Bayer, Illumina, Roche, erhält Forschungsförderung von AstraZeneca, Boehringer Ingelheim, Pfizer, PharmaMar und Roche, sowie Unterstützung von Amgen, Eli Lilly, Illumina, PharmaMar und Roche und erhielt Vortragshonorare von Amgen, Eli Lilly, PharmaMar, sowie Roche.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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G. Hasenfuß, Göttingen
S. von Haehling, Göttingen
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Lehmann, L.H., Fröhling, S. Mechanismen der Kardiotoxizität onkologischer Therapien. Internist 61, 1132–1139 (2020). https://doi.org/10.1007/s00108-020-00881-2
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DOI: https://doi.org/10.1007/s00108-020-00881-2