Лекарственно-индуцированное удлинение интервала QT на фоне применения противоопухолевых препаратов
Лекарственно-индуцированное удлинение интервала QT на фоне применения противоопухолевых препаратов
Остроумова О.Д., Кочетков А.И., Дё В.А. Лекарственно-индуцированное удлинение интервала QT на фоне применения противоопухолевых препаратов. Consilium Medicum. 2022;24(6):391–398.
DOI: 10.26442/20751753.2022.6.201542
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Ostroumova OD, Kochetkov AI, De VA. Cancer treatment and drug-induced QT interval prolongation: A review. Consilium Medicum. 2022;24(6):391–398. DOI: 10.26442/20751753.2022.6.201542
Лекарственно-индуцированное удлинение интервала QT на фоне применения противоопухолевых препаратов
Остроумова О.Д., Кочетков А.И., Дё В.А. Лекарственно-индуцированное удлинение интервала QT на фоне применения противоопухолевых препаратов. Consilium Medicum. 2022;24(6):391–398.
DOI: 10.26442/20751753.2022.6.201542
________________________________________________
Ostroumova OD, Kochetkov AI, De VA. Cancer treatment and drug-induced QT interval prolongation: A review. Consilium Medicum. 2022;24(6):391–398. DOI: 10.26442/20751753.2022.6.201542
Противоопухолевые препараты могут вызывать лекарственно-индуцированное удлинение интервала QT. В свою очередь, удлинение интервала QT является признанным фактором риска и независимым предиктором развития жизнеугрожающих желудочковых аритмий (прежде всего – полиморфной желудочковой тахикардии/Torsades de Pointes) и внезапной сердечной смерти у лиц как с наличием структурной патологии сердца, так и с ее отсутствием. Практикующие врачи должны постоянно оценивать отношение польза/риск при начале, а также продолжении выбранной терапии. Особое внимание необходимо обратить на пациентов с факторами риска, такими как наличие сопутствующих заболеваний, прием препаратов, ассоциированных с удлинением QT-интервала, дегидратация и электролитные нарушения и др. Несмотря на очевидный рост осведомленности пациентов и медицинского персонала, многие исследователи высказывают предположение о недостаточной степени информированности об истинной распространенности рассматриваемых нежелательных реакций, которая на самом деле превышает имеющиеся в настоящее время данные по меньшей мере в 10 раз. В данной статье рассматриваются противоопухолевые препараты, которые могут быть ассоциированы с удлинением интервала QT, а также особенности тактики ведения пациентов с лекарственно- индуцированным удлинением интервала QT.
Anticancer drugs can cause drug-induced prolongation of the QT interval. Prolongation of the QT interval is a known risk factor and an independent predictor of the development of life-threatening ventricular arrhythmias (polymorphic ventricular tachycardia, also called Torsades de Pointes), and sudden cardiac death in patients with and without structural heart disease. Healthcare practitioners should constantly evaluate the benefit/risk ratio prior to initiating treatment as well as continuing the chosen one. Some patients need particular attention, especially those who have risk factors such as comorbidities, taking drugs associated with QT interval prolongation, dehydration and electrolyte imbalance, etc. Despite apparent increase in the awareness among the patients and medical professionals, many scientists suggest that there is a lack of awareness about the true prevalence of these adverse events, which are at least 10 times greater than reported cases. This article discusses anticancer drugs that have an association with QT interval prolongation, and also possible strategies in the treatment of the patients with drug-induced QT interval prolongation.
Keywords: drug-induced disease, QT interval prolongation, torsade de pointes, cancer, anticancer drug
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________________________________________________
1. Cibulkin NA. Long QT syndrome – main clinical and pathophysiological aspects. Prakticheskaja medicina. 2012;5(60):98-103 (in Russian).
2. Haddad PM, Anderson IM. Antipsychotic-Related QTc Prolongation, Torsade de Pointes and Sudden Death. Drugs. 2002;62(11):1649-71. DOI:10.2165/00003495-200262110-00006
3. Ventricular arrhythmias. Ventricular tachycardia and sudden cardiac death. Clinical recommendations of the Ministry of Health of the Russian Federation. 2020. Available at: https://mz19.ru/upload/iblock/dea/ZHeludochkovye-narusheniya-ritma.-ZHeludochkovye-takhikardii-2020..... Accessed 29.12.2021 (in Russian).
4. Golovina GA, Zafiraki VK, Kosmacheva EV. Drug-induced long QT syndrome. Vestnik aritmologii. 2020;27(3):42-52 (in Russian).
5. Aktürk G, Kalkan Ş. Drug-Induced QT Interval Prolongation: Mechanisms, Risk Factors, Genetics and Clinical Management. J Basic Clin Health Sci. 2019;3(5):193-8. DOI:10.30621/jbachs.2019.712
6. Nachimuthu S, Assar MD, Schussler JM. Drug-induced QT interval prolongation: mechanisms and clinical management. Ther Adv Drug Saf. 2012;3(5):241-53. DOI:10.1177/2042098612454283
7. Vejpongsa P, Yeh ET. Prevention of anthracycline-induced cardiotoxicity: challenges and opportunities. J Am Coll Cardiol. 2014;64(9):938-45. DOI:10.1016/j.jacc.2014.06.1167
8. Sarapa N, Huang M, Varterasian M, et al. Risk management and eligibility critieria for QT assessment in patients with advanced cancer. J Clin Oncol. 2005;23(16; Suppl.):3047.
9. Yusuf SW, Razeghi P, Yeh ETH. The Diagnosis and Management of Cardiovascular Disease in Cancer Patients. Curr Probl Cardiol. 2008;33(4):163-96. DOI:10.1016/j.cpcardiol.2008.01.002
10. Ostroumova OD, Goloborodova IV. The influence of certain groups of drugs on the QTc interval prolongation. Consilium Medicum. 2019;21(10):95-106 (in Russian). DOI:10.26442/20751753.2019.10.190447
11. Ostroumova OD, Goloborodova IV. Drug-induced prolongation of the QT interval: prevalence, risk factors, treatment and prevention. Consilium Medicum. 2019;21(5):62-7 (in Russian). DOI:10.26442/20751753.2019.5.190415
12. Woosley RL, Heise CW, Gallo T. CredibleMeds. Available at: https://crediblemeds.org/ Accessed: 29.12.2021.
13. Porta-Sánchez A, Gilbert C, Spears D, et al. Incidence, Diagnosis, and Management of QT Prolongation Induced by Cancer Therapies: A Systematic Review. J Am Heart Assoc. 2017;6(12):007724. DOI:10.1161/JAHA.117.007724
14. Roden DM. A current understanding of drug-induced QT prolongation and its implications for anticancer therapy. Cardiovasc Res. 2019;115(5):895-903. DOI:10.1093/cvr/cvz013
15. Cohen-Rabbie S, Berges AC, Rekić D, et al. QT Prolongation Risk Assessment in Oncology: Lessons Learned From Small-Molecule New Drug Applications Approved During 2011–2019. J Clin Pharmacol. 2021;61(8):1106-17. DOI:10.1002/jcph.1844
16. Lazzerini PE, Bertolozzi I, Acampa M, et al. Androgen Deprivation Therapy for Prostatic Cancer in Patients With Torsades de Pointes. Front Pharmacol. 2020;11:684. DOI:10.3389/fphar.2020.00684
17. Abu Rmilah AA, Lin G, Begna KH, et al. Risk of QTc prolongation among cancer patients treated with tyrosine kinase inhibitors. Int J Cancer. 2020;147(11):3160-7. DOI:10.1002/ijc.33119
18. Cortes JE, Gambacorti-Passerini C, Deininger MW, et al. Bosutinib Versus Imatinib for Newly Diagnosed Chronic Myeloid Leukemia: Results From the Randomized BFORE Trial. J Clin Oncol. 2018;36(3):231-7. DOI:10.1200/JCO.2017.74.7162
19. Larkin J, Del Vecchio M, Ascierto PA, et al. Vemurafenib in patients with BRAF(V600) mutated metastatic melanoma: an open-label, multicentre, safety study. Lancet Oncol. 2014;15(4):436-44. DOI:10.1016/S1470-2045(14)70051-8
20. Duan J, Tao J, Zhai M, et al. Anticancer drugs-related QTc prolongation, torsade de pointes and sudden death: current evidence and future research perspectives. Oncotarget. 2018;9(39):25738-49. DOI:10.18632/oncotarget.25008
21. Dréno B, Ribas A, Larkin J, et al. Incidence, course, and management of toxicities associated with cobimetinib in combination with vemurafenib in the coBRIM study. Ann Oncol. 2017;28(5):1137-44. DOI:10.1093/annonc/mdx040
22. Jänne PA, Yang JC, Kim DW, et al. AZD9291 in EGFR inhibitor-resistant non-small-cell lung cancer. N Engl J Med. 2015;372(18):1689-99. DOI:10.1056/NEJMoa1411817
23. Schiefer M, Hendriks LEL, Dinh T, et al. Current perspective: Osimertinib-induced QT prolongation: new drugs with new side-effects need careful patient monitoring. Eur J Cancer. 2018;91:92-8. DOI:10.1016/j.ejca.2017.12.011
24. Hortobagyi GN. Ribociclib for the first-line treatment of advanced hormone receptor-positive breast cancer: a review of subgroup analyses from the MONALEESA-2 trial. Breast Cancer Res. 2018;20(1):123. DOI:10.1186/s13058-018-1050-7
25. Khozin S, Blumenthal GM, Zhang L, et al. FDA approval: ceritinib for the treatment of metastatic anaplastic lymphoma kinase-positive non-small cell lung cancer. Clin Cancer Res. 2015;21(11):2436-9. DOI:10.1158/1078-0432.CCR-14-3157
26. Wang H, Cao Q, Dudek AZ. Phase II study of panobinostat and bortezomib in patients with pancreatic cancer progressing on gemcitabine-based therapy. Anticancer Res. 2012;32(3):1027-31.
27. Lenihan DJ, Kowey PR. Overview and management of cardiac adverse events associated with tyrosine kinase inhibitors. Oncologist. 2013;18:900-8.
DOI:10.1634/theoncologist.2012-0466
28. Barbey JT, Pezzullo JC, Soignet SL. Effect of arsenic trioxide on QT interval in patients with advanced malignancies. J Clin Oncol. 2003;21:3609-15. DOI:10.1200/JCO.2003.10.009
29. Wacker A, Lersch C, Scherpinski U, et al. High incidence of angina pectoris in patients treated with 5-fluorouracil. A planned surveillance study with 102 patients. Oncology. 2003;65(2):108-12. DOI:10.1159/000072334
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Авторы
О.Д. Остроумова*1,2, А.И. Кочетков1, В.А. Дё1
1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*ostroumova.olga@mail.ru
________________________________________________
Olga D. Ostroumova*1,2, Aleksey I. Kochetkov1, Valeria A. De1
1 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
2 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*ostroumova.olga@mail.ru