Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Drug Saf. 2023 Sep;46(9):819-833. doi: 10.1007/s40264-023-01320-5. Epub 2023 Jun 21.
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment and care of patients with cancer owing to unique features, including the occurrence of the so-called immune-related adverse events (irAEs). A multidisciplinary team, possibly including a cardio-oncology specialist, is warranted to achieve a favorable patient outcome. Cardiovascular toxicity, especially myocarditis, emerged as a life-threatening irAE in the real-word setting, and the European Society of Cardiology has recently published the first guideline on cardio-oncology to increase awareness and promote a standardized approach to tackle this complex multimodal issue, including diagnostic challenges, assessment, treatment, and surveillance of patients with cancer receiving ICIs. In this article, through a question & answer format made up of case vignettes, we offer a clinically oriented overview on the latest advancements of ICI-related cardiovascular toxicity, focusing on myocarditis and associated irAEs (myositis and myasthenia gravis within the so-called overlap syndrome), with the purpose of assisting clinicians and healthcare professionals in daily clinical practice.
免疫检查点抑制剂 (ICIs) 以其独特的特性，包括所谓的免疫相关不良事件 (irAEs) 的发生，彻底改变了癌症患者的治疗和护理。为了实现良好的患者预后，可能需要一个多学科团队，包括心脏病学肿瘤专家。心血管毒性，特别是心肌炎，在真实环境中已成为一种危及生命的 irAE，欧洲心脏病学会最近发布了首份关于心脏病学肿瘤学的指南，以提高认识并促进采用标准化方法来解决这一复杂的多模式问题，包括诊断挑战、评估、治疗和接受 ICI 治疗的癌症患者的监测。在本文中，我们通过由病例简述组成的问答形式，提供了关于 ICI 相关心血管毒性的最新进展的临床导向概述，重点关注心肌炎和相关的 irAEs（所谓重叠综合征中的肌炎和重症肌无力），目的是帮助临床医生和医疗保健专业人员在日常临床实践中。
