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1/12/26

ABSTRACT

With the progression of tumor treatment, the 5-year survival rate of breast cancer is close to 90%. Cardiovascular toxicity caused by chemotherapy has become a vital factor affecting the survival of patients with breast cancer. Anthracyclines, such as doxorubicin, are still some of the most effective chemotherapeutic agents, but their resulting cardiotoxicity is generally considered to be progressive and irreversible. In addition to anthracyclines, platinum- and alkyl-based antitumor drugs also demonstrate certain cardiotoxic effects. Targeted drugs have always been considered a relatively safe option. However, in recent years, some random clinical trials have observed the occurrence of subclinical cardiotoxicity in targeted antitumor drug users, which may be related to the effects of targeted drugs on the angiotensin converting enzyme, angiotensin receptor and β receptor. The use of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and beta-blockers may prevent clinical cardiotoxicity. This article reviews the toxicity and mechanisms of current clinical anti-breast cancer drugs and proposes strategies for preventing cardiovascular toxicity to provide recommendations for the clinical prevention and treatment of chemotherapy-related cardiomyopathy.

PMID:37647693 | DOI:10.1016/j.biopha.2023.115373

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PubMed articles on: Cardio-Oncology

Hospitalization for acute heart failure during non-working hours impacts on long-term mortality: the REPORT-HF registry

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PubMed articles on: Cardio-Oncology

Cell membrane-camouflaged bufalin targets NOD2 and overcomes multidrug resistance in pancreatic cancer

Drug Resist Updat. 2023 Aug 21;71:101005. doi: 10.1016/j.drup.2023.101005. Online ahead of print.

ABSTRACT

AIMS: Multidrug resistance in pancreatic cancer poses a significant challenge in clinical treatment. Bufalin (BA), a compound found in secretions from the glands of toads, may help overcome this problem. However, severe cardiotoxicity thus far has hindered its clinical application. Hence, the present study aimed to develop a cell membrane-camouflaged and BA-loaded polylactic-co-glycolic acid nanoparticle (CBAP) and assess its potential to counter chemoresistance in pancreatic cancer.

METHODS: The toxicity of CBAP was evaluated by electrocardiogram, body weight, distress score, and nesting behavior of mice. In addition, the anticarcinoma activity and underlying mechanism were investigated both in vitro and in vivo.

RESULTS: CBAP significantly mitigated BA-mediated acute cardiotoxicity and enhanced the sensitivity of pancreatic cancer to several clinical drugs, such as gemcitabine, 5-fluorouracil, and FOLFIRINOX. Mechanistically, CBAP directly bound to nucleotide-binding and oligomerization domain containing protein 2 (NOD2) and inhibited the expression of nuclear factor kappa-light-chain-enhancer of activated B cells. This inhibits the expression of ATP-binding cassette transporters, which are responsible for chemoresistance in cancer cells.

CONCLUSIONS: Our findings indicate that CBAP directly inhibits NOD2. Combining CBAP with standard-of-care chemotherapeutics represents a safe and efficient strategy for the treatment of pancreatic cancer.

PMID:37647746 | DOI:10.1016/j.drup.2023.101005

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PubMed articles on: Cardio-Oncology

Heterotopia of salivary gland tissue in the pancreas

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PubMed articles on: Cancer & VTE/PE

Incidence of Pulmonary and Respiratory Conditions in Gaucher Disease from 2000 to 2020: A Multi-institutional Cohort Study

In Vivo. 2023 Sep-Oct;37(5):2276-2283. doi: 10.21873/invivo.13330.

ABSTRACT

BACKGROUND/AIM: Gaucher disease (GD) is a rare lysosomal storage disorder that can involve the lungs and pulmonary vasculature. The long-term effects of GD on respiratory health remain unclear due to limited data on the natural history of this disease. We analyzed electronic health records for 11,004 patients with GD over 10-20 years to determine the incidence of pulmonary hypertension (PH), lung disease, and other respiratory comorbidities and better understand disease course to guide management.

PATIENTS AND METHODS: We conducted a retrospective cohort study using the TriNetX research database of 130 million international patients. The incidence of primary/secondary PH, pulmonary heart disease, interstitial/obstructive/restrictive lung disease, pulmonary hemorrhage, and pulmonary embolism was assessed in patients with GD from 2000-2020.

RESULTS: Incidence rates of all conditions assessed increased from 10 to 20 years of follow-up. Excess risk of PH, lung disease, and pulmonary hemorrhage was significantly higher in GD patients after 20 versus 10 years.

CONCLUSION: Extended follow-up in GD is associated with substantially higher risks of PH, lung disease and other respiratory comorbidities, highlighting the need for close monitoring and early intervention to mitigate long-term pulmonary decline. Improved understanding of mechanisms driving respiratory deterioration can support the development of novel treatments to optimize outcomes in this population at high risk of pulmonary morbidity and mortality.

PMID:37652520 | DOI:10.21873/invivo.13330

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PubMed articles on: Cancer & VTE/PE

Epidemiology and clinical patterns of Lung Abscesses in ICU: A French multicenter retrospective study

Chest. 2023 Aug 29:S0012-3692(23)05371-0. doi: 10.1016/j.chest.2023.08.020. Online ahead of print.

ABSTRACT

BACKGROUND: Data are scarce regarding epidemiology and management of critically ill patients with lung abscesses.

RESEARCH QUESTION: What are the clinical and microbiological characteristics of critically ill patients with lung abscesses, how are they managed in the ICUs, and what are the risk factors of in-ICU mortality?

STUDY DESIGN AND METHODS: Retrospective observational multicenter study, based on ICD-10 codes, between 2015 and 2022 in France. In-ICU mortality-associated factors were determined by multivariate logistic regression.

RESULTS: We analyzed 171 ICU patients with pulmonary abscesses. 78% were male with a mean age of 56.5 ± 16.4 years. 20.4% were excessive alcohol users, 25.2% had a chronic lung disease (14% COPD), and 20.5% had a history of cancer. Overall, 40.9% were immunocompromised and 38% qualified for nosocomial infection. Presenting symptoms included fatigue or weight loss in 62%, fever (50.3%) and dyspnea (47.4%). Hemoptysis was reported in 21.7%. A polymicrobial infection was present in 35.6%. The most frequent pathogens were Enterobacteriaceae in 31%, S. aureus in 22% and Pseudomonas aeruginosa in 19.3%. 10.5% were fungal infections. Several clusters of clinico-radiological patterns were associated with specific microbiological documentation and could guide empiric antibiotic regimen. 11.7% had percutaneous abscess drainage; surgery was performed in 12.7%, and 12% required bronchial-artery embolization for hemoptysis. In-ICU mortality was 21.5%, and age [OR: 1.05 (1.02-1.91), P=0.007], RRT during ICU stay [OR: 3.56 (1.24-10.57), P=0.019], and fungal infection [OR: 9.12 (2.69-34.5), P=0.0006] were independent predictors of mortality after multivariate logistic regression, while drainage or surgery were not.

INTERPRETATION: Pulmonary abscesses in the ICU are a rare but severe disease often resulting from a polymicrobial infection with a high proportion of Enterobacteriaceae, S. aureus, and P. aeruginosa. Percutaneous drainage, surgery or arterial embolization was required in more than a third of cases. Further prospective studies focusing on first-line antimicrobial therapy and source control procedure are warranted to improve and standardize patient management.

PMID:37652296 | DOI:10.1016/j.chest.2023.08.020