Antiplatelet and Wound Healing Implications of Immunotherapy and Targeted Cancer Therapies in the Perioperative Period.

Autor:	Sindt JE; Division of Pain Medicine, Department of Anesthesiology, University of Utah-Huntsman Cancer Institute, Salt Lake City, Utah., Fitzgerald LA; Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah-Huntsman Cancer Institute, Salt Lake City, Utah., Kuznicki J; Department of Pharmacy, University of Utah-Huntsman Cancer Institute, Salt Lake City, Utah., Prelewicz S; Department of Pharmacy, University of Utah-Huntsman Cancer Institute, Salt Lake City, Utah., Odell DW; Division of Pain Medicine, Department of Anesthesiology, University of Utah-Huntsman Cancer Institute, Salt Lake City, Utah., Brogan SE; Division of Pain Medicine, Department of Anesthesiology, University of Utah-Huntsman Cancer Institute, Salt Lake City, Utah.
Jazyk:	angličtina
Zdroj:	Anesthesiology [Anesthesiology] 2023 Oct 01; Vol. 139 (4), pp. 511-522.
DOI:	10.1097/ALN.0000000000004669
Abstrakt:	The traditional paradigm of oncologic treatment centered on cytotoxic chemotherapy has undergone tremendous advancement during the last 15 yr with the advent of immunotherapy and targeted cancer therapies. These agents, including small molecule inhibitors, monoclonal antibodies, and immune-checkpoint inhibitors, are highly specific to individual tumor characteristics and can prevent cell growth and tumorigenesis by inhibiting specific molecular targets or single oncogenes. While generally better tolerated than traditional chemotherapy, these therapies are associated with unique constellations of adverse effects. Of particular importance in the perioperative and periprocedural settings are hematologic abnormalities, particularly antiplatelet effects with increased risk of bleeding, and implications for wound healing. This narrative review discusses targeted cancer therapies and provides recommendations for physicians managing these patients' care as it relates to procedural or surgical interventions. (Copyright © 2023 American Society of Anesthesiologists. All Rights Reserved.)
Databáze:	MEDLINE
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