Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut; Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
J Thorac Oncol. 2019 Jun;14(6):1102-1108. doi: 10.1016/j.jtho.2019.02.026. Epub 2019 Mar 7.
Side effects of immune checkpoint inhibitors, termed immune-related adverse events, are relatively common, but immune checkpoint inhibitor-mediated cardiotoxicities are rare; however, they can be serious and potentially fatal. Pericarditis is an infrequent cardiac toxicity of immunotherapy and predisposing factors remain unknown. Here we report three patients with NSCLC who developed pericarditis during therapy with programmed death 1/programmed death ligand 1+/- CTLA-4 inhibitors. We review the clinical presentation of these three cases and histopathologic findings from autopsies from the first two patients and a pericardial sampling that has been obtained from a pericardial window procedure in the third patient who recovered from the pericarditis episode. We also discuss the potential mechanisms, as well as what is known about pericarditis secondary to immune-related adverse events.
免疫检查点抑制剂的副作用，称为免疫相关不良反应，相对常见，但免疫检查点抑制剂介导的心脏毒性较为罕见；然而，它们可能很严重，甚至可能致命。心包炎是免疫治疗的一种罕见的心脏毒性，其诱发因素尚不清楚。在这里，我们报告了三例 NSCLC 患者在接受程序性死亡 1/程序性死亡配体 1+/CTLA-4 抑制剂治疗期间发生心包炎。我们回顾了这三例患者的临床表现，并对前两例患者的尸检组织病理学发现以及从第三例患者的心包窗手术中获得的心包样本进行了研究，该患者心包炎已痊愈。我们还讨论了潜在的机制，以及已知的免疫相关不良反应引起的心包炎。
