Symposium 16
3月27日［土］17:20-18:50
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Cancer chemotherapy and cardiovascular complications
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がんは治療の進歩によって、治療と回復が十分に可能な病気となりつつある。それにともなって、がんサバイバーが増加し、がん治療による循環器合併症が生命予後やQOLに影響する大きな要因となってきている。とくに、アントラサイクリン系抗がん剤のように心毒性が古くから知られた薬剤に加えて、様々な分子標的薬による循環器合併症が問題となっている。心血管系の恒常性維持に関わる分子を標的とする抗がん剤も多いが、オフターゲット効果の可能性もあり、分子標的薬でさえ循環器合併症発症の機序は不明な点が多い。また、がん薬物療法は治療プロトコールが多様であり、がん種やステージ、循環器疾患の既往や合併など患者背景も複雑なため、がん化学療法による循環器合併症に関する臨床研究・疫学研究のエビデンスは十分とは言い難い。そのような状況の中で、がん診療科と循環器科が連携・協働して、有効ながん治療の実施や継続のために心血管リスクの管理や心血管合併症への対応を行うことが求められている。本シンポジウムでは、がん化学療法による循環器合併症に関する最新の基礎研究および臨床研究・疫学研究の成果を踏まえながら、腫瘍循環器学の現状と今後の課題について討議したい。
Recent advancements in cancer therapy dramatically improved the long-term outcome of cancer patients, leading to an increase in the number of cancer survivors, but cardiovascular adverse events owing to cancer therapy have greater impact on the prognosis and quality of life in cancer patients and survivors. Under such circumstances, it is increasingly of importance to manage the cardiovascular complications, which are related to both cancer itself and adverse effects of cancer therapies. In addition to anthracyclines, whose cardiotoxic effects have been recognized for decades, molecularly targeted anticancer drugs have entered a list, for which cardiovascular complications are concerned. Anticancer drugs often target molecules essential to cardiovascular homeostasis, but off-target effects can also induce toxic phenotype. Currently, the molecular mechanisms underlying the pathogenesis of cardiovascular toxicity by individual drugs remain to be precisely defined. In addition, epidemiological and clinical aspects of cardiovascular complications by cancer chemotherapy have not been sufficiently accumulated, due to a wide variety of chemotherapy regimens and patient characteristics involving cancer types, stages, and cardiovascular comorbidities. Under such circumstances, interdisciplinary collaboration between oncology and cardiology specialists is the prerequisite for the best management of cardiovascular risks and complications to avoid interruption of optimal cancer treatment. In this symposium, we will discuss the current status and future directions of cardio-oncology/onco-cardiology, based on cutting-edge basic, clinical, and epidemiological research on cardiovascular complications in relation to cancer chemotherapy.
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Hiroshi Akazawa
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo
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Alexander Lyon
Cardio-Oncology Service and National Heart and Lung Institute, Royal Brompton Hospital and Imperial College London, UK
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Alexander Lyo
Cardio-Oncology Service and National Heart and Lung Institute, Royal Brompton Hospital and Imperial College London, UK
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Yoshiro Tanaka
Division of Cardiology, The Jikei University School of Medicine, Tokyo
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Koichiro Sugimura
Department of Cardiology, International University of Health and Welfare School of Medicine, Narita
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Hiroshi Kadowaki
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo
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Asuka Furukawa
Department of Cardiology, International University of Health and Welfare Mita Hospital, Tokyo
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Yuji Nishimoto
Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki
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