免疫检查点抑制剂治疗后的心血管毒性：一项系统评价与荟萃分析。

Cardiovascular toxicity following immune checkpoint inhibitors: A systematic review and meta-analysis.

作者信息

Xavier Camila Bragança, Lopes Carlos Diego Holanda, Harada Guilherme, Peres Eduardo Dante Bariani, Katz Artur, Jardim Denis Leonardo

机构信息

Oncology Center - Hospital Sírio-Libanês, São Paulo, Brazil.

Cardiology Center - Hospital Sírio-Libanês, São Paulo, Brazil.

出版信息

Transl Oncol. 2022 May;19:101383. doi: 10.1016/j.tranon.2022.101383. Epub 2022 Mar 3.

BACKGROUND

Immune checkpoint inhibitors may be associated with multiple immune-related toxicities. Cardiovascular adverse effects are underreported in clinical trials.

METHODS

We conducted a systematic review and meta-analysis to evaluate cardiovascular adverse effects incidence among patients with solid tumors receiving immune checkpoint inhibitors in randomized clinical trials and the relative risk of presenting these effects compared to placebo or best supportive care. The search was conducted through MEDLINE, Embase, and Scopus databases from January 1st, 2010 until July 1st, 2020. Outcomes were reported following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

RESULTS

57 randomized clinical trials including 12,118 patients were included. All grade CV AEs incidence rate was 8.32% (95% CI = 6.35%-10.53%). When only grade 3-5 CV AEs were considered, ICIs were significantly associated with increased risk than placebo or BSC (RR = 1.36; 95% CI = 1.06-1.73; p = 0.01).

CONCLUSION

This meta-analysis corroborates the hypothesis of increased CV risk related to immune checkpoint inhibitors.

背景

免疫检查点抑制剂可能与多种免疫相关毒性有关。心血管不良反应在临床试验中的报告不足。

方法

我们进行了一项系统评价和荟萃分析，以评估在随机临床试验中接受免疫检查点抑制剂的实体瘤患者中心血管不良反应的发生率，以及与安慰剂或最佳支持治疗相比出现这些不良反应的相对风险。检索于2010年1月1日至2020年7月1日通过MEDLINE、Embase和Scopus数据库进行。结果按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行报告。