Cardiovascular disease burden in patients with urological cancers: The new discipline of uro-cardio-oncology

Cancer Innovation Pub Date : 2024-02-05 DOI:10.1002/cai2.108
Yi Zheng, Ying Liu, Ziliang Chen, Yunpeng Zhang, Zuo Qi, Ning Wu, Zhiqiang Zhao, Gary Tse, Yong Wang, Hailong Hu, Yuanjie Niu, Tong Liu
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Abstract

Cancer remains a major cause of mortality worldwide, and urological cancers are the most common cancers among men. Several therapeutic agents have been used to treat urological cancer, leading to improved survival for patients. However, this has been accompanied by an increase in the frequency of survivors with cardiovascular complications caused by anticancer medications. Here, we propose the novel discipline of uro-cardio-oncology, an evolving subspecialty focused on the complex interactions between cardiovascular disease and urological cancer. In this comprehensive review, we discuss the various cardiovascular toxicities induced by different classes of antineoplastic agents used to treat urological cancers, including androgen deprivation therapy, vascular endothelial growth factor receptor tyrosine kinase inhibitors, immune checkpoint inhibitors, and chemotherapeutics. In addition, we discuss possible mechanisms underlying the cardiovascular toxicity associated with anticancer therapy and outline strategies for the surveillance, diagnosis, and effective management of cardiovascular complications. Finally, we provide an analysis of future perspectives in this emerging specialty, identifying areas in need of further research.

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泌尿系统癌症患者的心血管疾病负担:泌尿心血管肿瘤学这门新学科
癌症仍然是全球死亡的主要原因,而泌尿系统癌症是男性最常见的癌症。目前已有多种治疗药物用于治疗泌尿系统癌症,从而提高了患者的生存率。然而,与此同时,因抗癌药物引起心血管并发症的幸存者人数也在增加。在此,我们提出了泌尿心血管肿瘤学这一新兴学科,它是一个不断发展的亚专科,重点研究心血管疾病与泌尿系统癌症之间复杂的相互作用。在这篇综述中,我们讨论了用于治疗泌尿系统癌症的各类抗肿瘤药物诱发的各种心血管毒性,包括雄激素剥夺疗法、血管内皮生长因子受体酪氨酸激酶抑制剂、免疫检查点抑制剂和化疗药物。此外,我们还讨论了与抗癌治疗相关的心血管毒性的可能机制,并概述了心血管并发症的监测、诊断和有效管理策略。最后,我们分析了这一新兴专业的未来前景,确定了需要进一步研究的领域。
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