Tan Sean, Day Daphne, Nicholls Stephen J, Segelov Eva
Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia.
Monash Heart, Monash Health, Clayton, Victoria, Australia.
JACC CardioOncol. 2022 Dec 20;4(5):579-597. doi: 10.1016/j.jaccao.2022.09.004. eCollection 2022 Dec.
Immune checkpoint inhibitors (ICIs) are a major class of immuno-oncology therapeutics that have significantly improved the prognosis of various cancers, both in (neo)adjuvant and metastatic settings. Unlike other conventional therapies, ICIs elicit antitumor effects by enhancing host immune systems to eliminate cancer cells. There are 3 approved ICI classes by the U.S. Food and Drug Administration: inhibitors targeting cytotoxic T lymphocyte associated antigen 4, programmed death 1/programmed death-ligand 1, and lymphocyte-activation gene 3, with many more in development. ICIs are commonly associated with distinct toxicities, known as immune-related adverse events, which can arise during treatment or less frequently be of late onset, usually relating to excessive activation of the immune system. Acute cardiovascular immune-related adverse events such as myocarditis are rare; however, data suggesting chronic cardiovascular sequelae are emerging. This review presents the current landscape of ICIs in oncology, with a focus on important aspects relevant to cardiology.
免疫检查点抑制剂（ICIs）是一类主要的免疫肿瘤治疗药物，在（新）辅助治疗和转移性治疗中都显著改善了各种癌症的预后。与其他传统疗法不同，ICIs通过增强宿主免疫系统来消除癌细胞从而产生抗肿瘤作用。美国食品药品监督管理局已批准了3类ICIs：靶向细胞毒性T淋巴细胞相关抗原4、程序性死亡蛋白1/程序性死亡配体1和淋巴细胞激活基因3的抑制剂，还有更多药物正在研发中。ICIs通常与独特的毒性相关，即免疫相关不良事件，这些事件可能在治疗期间出现，或较少见地在较晚时候发生，通常与免疫系统过度激活有关。急性心血管免疫相关不良事件如心肌炎很少见；然而，提示慢性心血管后遗症的数据正在出现。本综述介绍了ICIs在肿瘤学中的现状，重点关注与心脏病学相关的重要方面。
