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PD-1/PDL-1 抑制剂与心脏毒性:分子、病因与管理概述。

PD-1/PDL-1 Inhibitors and Cardiotoxicity; Molecular, Etiological and Management Outlines.

机构信息

Department of Oncology, First Affiliated Hospital of Dalian Medical University, Zhongshan Road No. 222, Dalian 116021, China.

Department of Stomatology, Oral Pathology, Dalian Medical University, Zhongshan Road No. 222, Dalian 116021, China.

出版信息

J Adv Res. 2020 Oct 3;29:45-54. doi: 10.1016/j.jare.2020.09.006. eCollection 2021 Mar.

Abstract

BACKGROUND

The US Food and Drug Administration (FDA) has approved several immunotherapeutic drugs for cancer since 2010, and many more are still being evaluated in other clinical studies. These inhibitors significantly increase response rates and result in the treatment of patients with advanced cancer. However, cancer immunotherapy leads to essential cardiac toxicity properties that have become distinct from other cancer patients' care and are mostly related to their etiology.

AIM OF REVIEW

As potential implications, the occurrence of cardiovascular adverse events is particularly challenging and needs a comprehensive understanding of overall cancer-related etiology, clinical outcomes with different variable severity, and management.

KEY SCIENTIFIC CONCEPTS OF REVIEW

In terms of improving the overall survival of patients with cancer, clinicians should be careful in selecting either programmed cell death-1 (PD-1) or its programmed cell death ligand (PDL-1) inhibitors by evaluating their risk and clinical benefit for early intervention and decrease the level of morbidity and mortality of their patients. This review focuses on the effectiveness of PD-1/PL-1 antibodies and associated cardiotoxicity adverse events, including etiological mechanisms, diagnosis, and treatment.

摘要

背景

自 2010 年以来,美国食品和药物管理局(FDA)已批准了几种癌症免疫治疗药物,还有许多药物正在其他临床研究中进行评估。这些抑制剂显著提高了反应率,并使晚期癌症患者得到了治疗。然而,癌症免疫疗法导致了严重的心脏毒性,这与其他癌症患者的治疗不同,主要与病因有关。

目的

由于潜在的影响,心血管不良事件的发生尤其具有挑战性,需要全面了解与癌症相关的总体病因、不同严重程度的临床结果以及管理。

审查的关键科学概念

为了提高癌症患者的总体生存率,临床医生应通过评估其风险和临床获益来谨慎选择程序性细胞死亡蛋白-1(PD-1)或其程序性细胞死亡配体(PDL-1)抑制剂,以便进行早期干预,降低患者的发病率和死亡率。本综述重点介绍了 PD-1/PL-1 抗体及其相关的心脏毒性不良事件的有效性,包括病因机制、诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c078/8020146/35c7b83eb444/ga1.jpg

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