Vartanov Alexander, Kalotra Aditi, Varughese Jasmine, Gautam Shovendra, Kandel Sean, Hosmer Wylie
Department of Medicine, University of Connecticut School of Medicine, 263 Farmington Avenue L2104, Farmington, CT, 06030, USA.
Department of Medicine, Hospital of Central Connecticut, 100 Grand Street, New Britain, CT, 06052, USA.
Respir Med Case Rep. 2021 Mar 18;33:101390. doi: 10.1016/j.rmcr.2021.101390. eCollection 2021.
The role for PD-1/PD-L1 and CTLA-4 targeted immunotherapy is well outlined in the treatment of metastatic NSCLC. Increased survival benefit supports the use of these medications and the development of next-generation agents with improved efficacy and favorable side-effect profiles. The prevalence of immunotherapy-associated cardiotoxicity (IAC) has grown significantly over the past two years as awareness of this toxicity class has emerged. High-grade conduction disorders comprise a subset of cardiotoxicities with a high case fatality rate. We presented a case of suspected combination ipilimumab-nivolumab associated 3rd degree heart block. The onset of this event was 16 days after immunotherapy initiation. A literature review has suggested that over 75% of cases of cardiotoxicity are observed within the first 6 weeks. We present findings from an interrogation of the FDA Adverse Event Reporting System (FAERS) and provide clinical guidance for the early identification of high-risk patients.
PD-1/PD-L1和CTLA-4靶向免疫疗法在转移性非小细胞肺癌（NSCLC）治疗中的作用已得到充分阐述。生存获益的增加支持了这些药物的使用以及开发疗效更佳、副作用更小的新一代药物。在过去两年中，随着对免疫疗法相关心脏毒性（IAC）这一毒性类别的认识出现，其发生率显著上升。高度传导障碍是心脏毒性的一个子集，病死率很高。我们报告了一例疑似因联合使用伊匹木单抗和纳武单抗导致的三度心脏传导阻滞病例。该事件发生在免疫治疗开始后的16天。文献综述表明，超过75%的心脏毒性病例在最初6周内出现。我们展示了对美国食品药品监督管理局不良事件报告系统（FAERS）调查的结果，并为高危患者的早期识别提供临床指导。
