Allongement de l’intervalle QT secondaire aux inhibiteurs des tyrosines-kinases View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-01

AUTHORS

P. Debourdeau, A. Stancu, V. Debourdeau, D. Serin

ABSTRACT

Les inhibiteurs des tyrosines-kinases (ITK) sont une classe thérapeutique en expansion, dont les prescriptions augmentent avec l’identification de nouvelles cibles moléculaires et la mise sur le marché constante de nouvelles substances. Les effets secondaires les plus connus sont digestifs et cutanés. Les effets cardiovasculaires sont moins bien identifiés, car le plus souvent sans traduction clinique, et leur prise en charge reste mal codifiée: dysfonction myocardique, hypertension artérielle (HTA) et allongement de l’intervalle QT. L’allongement de l’intervalle QT reste mal dépisté faute de réalisation systématique d’électrocardiogramme (ECG). Il est cependant potentiellement mortel avec la survenue de torsade de pointe pouvant dégénérer en fibrillation ventriculaire. Cette toxicité est certaine pour le vandétanib, le vémurafénib, le sunitinib, le sorafénib, le nilotinib et le crizotinib. Elle est probable pour le lapatinib, l’erlotinib, le dasatinib et le bosutinib. Elle est certainement nulle pour les autres ITK, mais le recul est sans doute insuffisant pour certains d’entre eux. Un ECG de référence est donc conseillé. De même, une attention particulière doit être portée aux autres médicaments prescrits en cancérologie, en premier lieu les nombreuses substances utilisées pour les soins de support qui peuvent allonger l’intervalle QT et dans une moindre mesure les autres molécules métabolisées par le cytochrome 3A4 qui modifient le taux plasmatique des ITK. Une coopération entre oncologues, hématologues et cardiologues est donc indispensable. C’est pourquoi une plateforme coeur vaisseaux cancer se met sur pied en région PACA afin d’optimiser la prise en charge des patients et de prévenir les complications cardiovasculaires. More... »

PAGES

47-54

Journal

TITLE

Oncologie

ISSUE

1

VOLUME

18

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10269-015-2583-3

DOI

http://dx.doi.org/10.1007/s10269-015-2583-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1040815837


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