Ways of medicinal prevention and treatment of doxorubicin-induced cardiomyopathy in oncological patients

V. A. Moroz, R. Al-Hadrawi, O. Andrieieva, Y. Timchenko, A. M. Semenov
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Abstract

The high incidence of malignant tumors is currently supported by the general ageing of the world population and unfavorable environmental factors. In 2018, 18.1 million new cases of cancer and 9.6 million deaths from them were registered in the world. At the same time, a significant increase in the life expectancy of these patients after the treatment noted over the past 20 years highlights the problem of side effects of the anticancer therapy. One of the most serious side effects is the development of doxorubicin-induced cardiomyopathy (DRIC). In all three distinct clinical forms (acute, early and late) DRIC can develop in 58 % of patients after using anticancer treatment regimens with the inclusion of doxorubicin. The review provides a detailed analysis of medicinal treatment regimens and preparations (ACE inhibitors, beta-blockers, statins, etc.) currently used, and evaluates their effectiveness and expected results. Currently, several therapeutic strategies have been proposed for the prevention and treatment of DRIC, each of them has certain positive results. At the same time, some therapeutic methods used in the clinic have some disadvantages. Conclusions. The limitations of the results of DRIC prevention achieved by the existing therapeutic regimens, as well as the possibilities for their prediction, have been stated. The need for further research to improve the effectiveness of medicinal prevention and treatment of DRIC is emphasized.
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肿瘤患者多柔比星致心肌病的药物防治方法
恶性肿瘤的高发病率是目前世界人口普遍老龄化和不利环境因素共同作用的结果。2018年,全球登记的癌症新发病例为1810万例,死亡病例为960万例。与此同时,在过去的20年里,这些患者在接受治疗后的预期寿命显著增加,这凸显了抗癌治疗的副作用问题。最严重的副作用之一是阿霉素引起的心肌病(DRIC)。在所有三种不同的临床形式(急性、早期和晚期)中,58%的患者在使用含有阿霉素的抗癌治疗方案后可发生DRIC。本综述详细分析了目前使用的药物治疗方案和制剂(ACE抑制剂、β受体阻滞剂、他汀类药物等),并对其有效性和预期结果进行了评价。目前,针对DRIC的预防和治疗已经提出了几种治疗策略,每种策略都有一定的积极效果。同时,临床上采用的一些治疗方法也存在一定的不足。本文指出了现有治疗方案预防DRIC的局限性,以及预测DRIC的可能性。强调需要进一步研究以提高DRIC的药物预防和治疗效果。
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