Cardiovascular–kidney–metabolic (CKM) syndrome represents a complex interplay between cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders, significantly impacting cancer patients. The presence of CKM syndrome in cancer patients not only worsens their prognosis but also increases the risk of major adverse cardiovascular events (MACE), reduces quality of life (QoL), and affects overall survival (OS). Furthermore, several anticancer therapies, including anthracyclines, tyrosine kinase inhibitors, immune checkpoint inhibitors, and hormonal treatments, can exacerbate CKM syndrome by inducing cardiotoxicity, nephrotoxicity, and metabolic dysregulation. This review explores the pathophysiology of CKM syndrome in cancer patients and highlights emerging therapeutic strategies to mitigate its impact. We discuss the role of novel pharmacological interventions, including sodium-glucose cotransporter-2 inhibitors (SGLT2i), proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), and soluble guanylate cyclase (sGC) activators, as well as dietary and lifestyle interventions. Optimizing the management of CKM syndrome in cancer patients is crucial to improving OS, enhancing QoL, and reducing MACE. By integrating cardiometabolic therapies into oncologic care, we can create a more comprehensive treatment approach that reduces the burden of cardiovascular and renal complications in this vulnerable population. Further research is needed to establish personalized strategies for CKM syndrome prevention and treatment in cancer patients.
心血管-肾脏-代谢综合征体现了心血管疾病、慢性肾脏病与代谢紊乱之间的复杂相互作用，显著影响癌症患者。该综合征在癌症患者中的存在不仅会恶化其预后，还会增加主要不良心血管事件风险、降低生活质量并影响总生存期。此外，包括蒽环类药物、酪氨酸激酶抑制剂、免疫检查点抑制剂及激素治疗在内的多种抗癌疗法，可能通过诱导心脏毒性、肾毒性和代谢紊乱而加剧该综合征。本综述探讨了癌症患者中心血管-肾脏-代谢综合征的病理生理机制，并重点介绍了减轻其影响的新兴治疗策略。我们讨论了新型药物干预措施的作用，包括钠-葡萄糖协同转运蛋白2抑制剂、前蛋白转化酶枯草溶菌素9抑制剂和可溶性鸟苷酸环化酶激活剂，以及饮食和生活方式干预措施。优化癌症患者心血管-肾脏-代谢综合征的管理对于改善总生存期、提高生活质量和减少主要不良心血管事件至关重要。通过将心脏代谢治疗整合到肿瘤诊疗中，我们可以建立更全面的治疗方法，减轻这一脆弱人群的心血管和肾脏并发症负担。未来需要进一步研究以建立针对癌症患者心血管-肾脏-代谢综合征预防和治疗的个性化策略。
肿瘤(癌症)患者之家