Zhang Lili, Reynolds Kerry L, Lyon Alexander R, Palaskas Nicolas, Neilan Tomas G
Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Division of Oncology and Hematology, Department of Medicine, Massachusetts General Hospital, Massachusetts, USA.
JACC CardioOncol. 2021 Mar;3(1):35-47. doi: 10.1016/j.jaccao.2020.11.012. Epub 2021 Jan 12.
Immune checkpoint inhibitors (ICIs) are newer therapies being applied to an increasing number of patients with cancer. Data suggest that up to 36% of cancer patients may be eligible for immunotherapy and, in late 2019, there were more than 3,362 clinical trials initiated to evaluate the effectiveness of immunotherapy, either as single agents or in combination with other immunotherapy, targeted therapies, or traditional cytotoxic or radiation therapy. With the combination of both immune and non-immune treatment approaches, the complexity in making the diagnosis of cardiotoxicity related to an ICI will increase substantially. Here, we summarize the published data on the epidemiology, diagnosis, and management of cardiotoxicity of ICIs. This is a rapidly evolving field, and as our understanding continues to evolve, previously considered hypotheses may not prove to be entirely correct. Research and continued collaborations are urgently needed to provide evidence-based cardiovascular care for this rapidly expanding and vulnerable cohort of patients. (J Am Coll Cardiol CardioOnc 2021;3:35-47) © 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
免疫检查点抑制剂（ICIs）是应用于越来越多癌症患者的新型疗法。数据表明，高达36%的癌症患者可能适合接受免疫治疗，并且在2019年末，有超过3362项临床试验启动，以评估免疫治疗作为单一药物或与其他免疫治疗、靶向治疗、传统细胞毒性或放射治疗联合使用的有效性。随着免疫和非免疫治疗方法的结合，与ICI相关的心脏毒性诊断的复杂性将大幅增加。在此，我们总结了关于ICI心脏毒性的流行病学、诊断和管理的已发表数据。这是一个快速发展的领域，随着我们的认识不断发展，之前认为的假设可能并不完全正确。迫切需要开展研究并持续合作，为这一迅速扩大且脆弱的患者群体提供循证心血管护理。（《美国心脏病学会杂志：心血管肿瘤学》2021年；3：35 - 47）© 2021作者。由爱思唯尔代表美国心脏病学会基金会出版。这是一篇根据CC BY - NC - ND许可（http://creativecommons.org/licenses/by-nc-nd/4.0/）发布的开放获取文章。
