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分子靶向抗血管生成药物的毒性：对心血管的影响

Authors
Toni K Choueiri, MD
Guru Sonpavde, MD
Section Editors
Richard M Goldberg, MD
Michael B Atkins, MD
Richard A Larson, MD
Deputy Editors
Diane MF Savarese, MD
Jennifer S Tirnauer, MD
Translators
孙勇, 教授

引言

血管生成抑制剂在癌症治疗中的应用日益广泛。在认识到血管生成有促进肿瘤生长的作用之后[1]，多项试验表明，血管生成抑制剂治疗正在逐渐改善多种晚期实体瘤的结局。

随着以血管内皮生长因子(vascular endothelial growth factor, VEGF)信号传导通路为靶点的药物在癌症治疗中的广泛应用，人们越来越意识到，这些药物具有广泛的毒性作用，并且在少数情况下，这些毒性可能是致命的[2,3]。由于这些药物主要靶向肿瘤的血管系统而非肿瘤细胞本身，其许多毒性具有独特性，通常不会在使用常规的细胞毒性药物中观察到。

本专题将覆盖抗VEGF药物对心血管的不良作用，包括高血压(hypertension, HTN)、血栓栓塞性疾病、左心室(left ventricular, LV)功能不全、心肌缺血、QTc间期延长、血栓性微血管病。VEGF通路抑制剂的所有其他(非心血管)毒性作用，以及同时具有免疫调节活性与抗血管生成活性的药物(沙利度胺、来那度胺和泊马度胺)的血栓性并发症将会单独详细讨论。 (参见“抗血管生成分子靶向药物的毒性：非心血管影响”和“沙利度胺及其类似物治疗多发性骨髓瘤后的血栓形成性并发症”)

抗血管生成药物概述

目前已有几类可使用的抗血管生成药物。 (参见“血管生成抑制剂的概述”)

此处讨论的药物包括下列单克隆抗体和小分子药物：

                                      

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-26.
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