臨床検査66巻6号

2022年06月発行

今月の特集1 腫瘍循環器学を学ぶ

抗HER2療法による心筋障害

著者： 能勢拓¹

所属機関： ¹神戸大学医学部附属病院腫瘍・血液内科

ページ範囲：P.704 - P.711

Point

●抗ヒト上皮細胞増殖因子受容体2型（HER2）療法は，心筋細胞膜上に発現しているHER2からの下流シグナルを阻害することで心筋細胞死を促すとともに心筋修復を阻害し，心機能の低下を引き起こす．

●抗HER2療法による心筋障害は用量非依存性であり，無症候性の左室駆出率（LVEF）の低下であることが多い．発症しても休薬することで心機能の回復が期待でき，再投与も可能である．

●トラスツズマブはアントラサイクリン系抗がん薬と併用することで心毒性の発症頻度が上昇する．同時併用は心毒性のリスクが高く，現在行われていない．

●トラスツズマブ投与中はスクリーニングとして3カ月ごとのLVEF，GLSの評価と，サイクルごとにトロポニンIの測定を行う．

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