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免疫检查点抑制剂诱导的心脏毒性:对机制、监测、诊断和治疗的全面洞察。

Cardiotoxicity induced by immune checkpoint inhibitor: The complete insight into mechanisms, monitoring, diagnosis, and treatment.

作者信息

Ganesh Sridha, Zhong Peng, Zhou Xiaoyang

机构信息

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

Front Cardiovasc Med. 2022 Sep 20;9:997660. doi: 10.3389/fcvm.2022.997660. eCollection 2022.

Abstract

Immune checkpoint inhibitors (ICIs) have been taking cancer research by storm as they provide valuable therapeutic benefits to cancer patients in terms of immunotherapy. Melanoma and non-small cell lung cancer (NSCLC) are among the most prevalent cancer varieties that were utilized in ICI trials with many other cancer types being involved too. Despite impressive clinical benefits of overall response rate (ORR), progression-free survival (PFS), etc., ICIs are also accompanied by various immune-related adverse events (irAEs). Amongst the irAEs, cardiotoxicity bags a crucial role. It is of paramount importance that ICI-induced cardiotoxicity should be studied in detail due to its high mortality rate although the prevalence rate is low. Patients with ICI cardiotoxicity can have a greatly enhanced life quality despite adverse reactions from ICI therapy if diagnosed early and treated in time. As such, this review serves to provide a complete insight into the predisposing factors, mechanism, diagnostic methods and treatment plans revolving around ICI-induced cardiotoxicity.

摘要

免疫检查点抑制剂(ICIs)在癌症研究领域掀起了一场风暴,因为它们在免疫治疗方面为癌症患者提供了宝贵的治疗益处。黑色素瘤和非小细胞肺癌(NSCLC)是ICIs试验中最常见的癌症类型,其他许多癌症类型也参与其中。尽管总体缓解率(ORR)、无进展生存期(PFS)等临床益处令人印象深刻,但ICIs也伴随着各种免疫相关不良事件(irAEs)。在这些irAEs中,心脏毒性起着关键作用。尽管ICI诱导的心脏毒性发生率较低,但由于其高死亡率,对其进行详细研究至关重要。如果早期诊断并及时治疗,ICI心脏毒性患者尽管会出现ICI治疗的不良反应,但生活质量仍可大大提高。因此,本综述旨在全面深入了解围绕ICI诱导的心脏毒性的易感因素、机制、诊断方法和治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5939/9530557/f78998d74fae/fcvm-09-997660-g0001.jpg

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