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免疫检查点抑制剂心血管毒性的诊断与管理:心肌炎及其他

The Diagnosis and Management of Immune Checkpoint Inhibitor Cardiovascular Toxicity: Myocarditis and Beyond.

作者信息

Gilon Dan, Iakobishvili Zaza, Leibowitz David

机构信息

Cardio-Oncology, Heart Institute, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112001, Israel.

Cardio-Oncology, Cardiology Department, Shamir Governmental Medical Center (Assaf Harofeh), Rishon Lezion 7528809, Israel.

出版信息

Vaccines (Basel). 2022 Feb 16;10(2):304. doi: 10.3390/vaccines10020304.

Abstract

Recent years have brought major advancements in the use of immune therapy and specifically immune checkpoint inhibitors (ICIs) in cancer patients, with expanding indications for various malignancies resulting in the treatment of a large and increasing number of patients. While this therapy significantly improves outcomes in a variety of hematologic and solid tumors, the use of ICIs is associated with a substantial risk of immune-related adverse events. Cardiovascular toxicity, while not the most common side effect of ICIs, is associated with significant morbidity and mortality. It is therefore crucial for oncologists and cardiologists, as well as internists and emergency room physicians, to have a good understanding of this increasingly common clinical problem. In the present review, we discuss the cardiac aspects of ICI therapy with special emphasis on the clinical manifestations of their cardiovascular toxicity, diagnostic approaches, treatment and suggested surveillance.

摘要

近年来,免疫疗法尤其是免疫检查点抑制剂(ICI)在癌症患者中的应用取得了重大进展,各种恶性肿瘤的适应证不断扩大,导致接受治疗的患者数量大幅增加且持续增多。虽然这种疗法显著改善了多种血液系统肿瘤和实体瘤的治疗效果,但ICI的使用与免疫相关不良事件的重大风险相关。心血管毒性虽不是ICI最常见的副作用,但却与显著的发病率和死亡率相关。因此,肿瘤学家、心脏病学家以及内科医生和急诊室医生充分了解这一日益常见的临床问题至关重要。在本综述中,我们讨论ICI治疗的心脏方面,特别强调其心血管毒性的临床表现、诊断方法、治疗及建议的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b626/8879796/819b750d96a9/vaccines-10-00304-g001.jpg

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