Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, 41 Mall road, Burlington, MA 01805, USA; Cardio-Oncology and Adult Cancer Survivorship Program, Dana Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Department of Medicine, Western Reserve Health Education, 1350 East Market St, Warren, OH 44482, USA.
Cardiol Clin. 2019 Nov;37(4):385-397. doi: 10.1016/j.ccl.2019.07.008. Epub 2019 Aug 27.
The advent of immunotherapy, particularly immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy, has ushered in a promising new era of treatment of patients with a variety of malignancies who historically had a poor prognosis. However, these therapies are associated with potentially life-threatening cardiovascular adverse effects. As immunotherapy evolves to include a wider variety of malignancies, risk stratification, prompt recognition, and treatment of cardiotoxicity will become increasingly important and hence cardiologists will need to play a fundamental role in the comprehensive care of these patients. This article reviews cardiotoxicity associated with contemporary immunotherapy and discusses potential management strategies.
免疫疗法的出现,特别是免疫检查点抑制剂和嵌合抗原受体 T 细胞疗法,为历史上预后不良的多种恶性肿瘤患者带来了充满希望的治疗新时代。然而,这些疗法与潜在危及生命的心血管不良事件相关。随着免疫疗法的发展,涵盖了更多种类的恶性肿瘤,对心血管毒性进行风险分层、及时识别和治疗将变得越来越重要,因此心脏病专家将需要在这些患者的综合治疗中发挥重要作用。本文综述了与当代免疫疗法相关的心脏毒性,并讨论了潜在的管理策略。