Medical Oncology Unit, University Hospital of Parma, Parma, 43126, Italy.
Cardiology Unit, University Hospital of Parma, Parma, 43126, Italy.
Immunotherapy. 2022 Nov;14(16):1297-1305. doi: 10.2217/imt-2022-0013. Epub 2022 Nov 21.
We report the case of a patient with metastatic renal cell carcinoma who developed Takotsubo syndrome (TTS) 6 days after starting pembrolizumab plus axitinib as first-line treatment. Coronary angiogram was negative for obstructive coronary artery disease and echocardiogram revealed a depressed left ventricular ejection fraction with apical akinesis. Axitinib was discontinued and myocardial contractile function fully recovered 23 days after the initial presentation. The treatment was safely resumed and granted a partial response of disease. A literature review regarding TTS in patients receiving VEGFR tyrosine kinase inhibitors and/or immune checkpoint inhibitors was performed. TTS is reported as a rare adverse event and the possible causal relationship between TTS and antineoplastic therapy is still unclear. Further research is warranted to better understand cardiotoxicity mechanisms and their management.
我们报告了一例转移性肾细胞癌患者的病例，该患者在开始接受派姆单抗联合阿昔替尼作为一线治疗后 6 天发生 Takotsubo 综合征（TTS）。冠状动脉造影未发现阻塞性冠状动脉疾病，超声心动图显示左心室射血分数降低，心尖部无运动。停用阿昔替尼后，初始表现后 23 天心肌收缩功能完全恢复。治疗安全恢复，并使疾病部分缓解。对接受 VEGFR 酪氨酸激酶抑制剂和/或免疫检查点抑制剂的患者发生 TTS 的文献进行了回顾。TTS 是一种罕见的不良反应，TTS 与抗肿瘤治疗之间的可能因果关系尚不清楚。需要进一步研究以更好地了解心脏毒性机制及其管理。
