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应对与免疫检查点抑制剂相关的心脏毒性

Managing cardiotoxicity associated with immune checkpoint inhibitors.

作者信息

Upadhrasta Sireesha, Elias Hadi, Patel Keval, Zheng Lei

机构信息

Department of Internal Medicine, Saint Agnes Hospital, Baltimore, MD 21229, USA.

Department of Internal Medicine, University of Maryland, Baltimore, MD 21201, USA.

出版信息

Chronic Dis Transl Med. 2019 Mar 21;5(1):6-14. doi: 10.1016/j.cdtm.2019.02.004. eCollection 2019 Mar.

Abstract

Immuno-oncology is a fast evolving field of cancer therapy and immune checkpoint inhibitors (ICIs) are clearly a breakthrough in this field. Cardiotoxicity with conventional anti-cancer therapies has been well studied in the past and clear guidelines for management of these side effects are available in the literature. However, cardiotoxicity with novel agents such as ICIs has been fairly under-reported and/or underestimated and we are yet to formulate clear guidelines for management of these rare side effects. In the last few years, there has been an overall increase in the number of cases of cardiotoxicity related to ICIs. In this literature review, we describe the mechanism of action of the most widely used ICIs and their related cardiotoxicities. The increase in number of case reports about the potential of cardiotoxicities with these novel agents clearly indicates the need for a new insight into the field of cardio-immuno-oncology.

摘要

免疫肿瘤学是癌症治疗中一个快速发展的领域,免疫检查点抑制剂(ICIs)显然是该领域的一项突破。过去对传统抗癌疗法的心脏毒性已有充分研究,文献中也有针对这些副作用管理的明确指南。然而,诸如ICIs等新型药物的心脏毒性报告相对较少且/或被低估,我们尚未制定针对这些罕见副作用管理的明确指南。在过去几年中,与ICIs相关的心脏毒性病例数量总体有所增加。在这篇文献综述中,我们描述了最广泛使用的ICIs的作用机制及其相关心脏毒性。关于这些新型药物潜在心脏毒性的病例报告数量增加,清楚地表明需要对心脏免疫肿瘤学领域有新的认识。

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