Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy.
Division of Urology, European Institute of Oncology (IEO)-IRCCS, Milan, Italy.
Crit Rev Oncol Hematol. 2023 Aug;188:104059. doi: 10.1016/j.critrevonc.2023.104059. Epub 2023 Jun 21.
Anti-VEGF (vascular endothelial growth factor) agents were associated with increased risk of several cardiovascular events, while one meta-analysis did not show any significantly increased risk of cardiotoxicity associated with the use of immune checkpoint inhibitors (ICIs). This meta-analysis of randomized-controlled trials (RCTs) was designed to compare cardiovascular toxicity of anti-VEGF agents plus ICI vs anti-VEGF agents without ICIs. A systematic search of the literature was conducted to include all full papers reporting about phase II and III randomized controlled trials (RCTs) conducted in patients with solid malignancies randomized to an anti-VEGF agent plus an ICI vs. an anti-VEGF agent without an ICI. Overall incidences of cardiovascular events were compared between these two treatment groups estimating the corresponding odds ratios. This analysis suggests that ICIs may increase the risk of cardiovascular toxicities associated with anti-VEGF therapies. Further research, including real world studies, is warranted.
抗血管内皮生长因子（VEGF）药物与多种心血管事件的风险增加相关，而一项荟萃分析并未显示免疫检查点抑制剂（ICI）的使用与心脏毒性相关的风险显著增加。本荟萃分析旨在比较抗 VEGF 药物联合 ICI 与抗 VEGF 药物不联合 ICI 的心血管毒性。系统检索文献，纳入所有报告实体恶性肿瘤患者 II 期和 III 期随机对照试验（RCT）的全文，这些患者随机分配至抗 VEGF 药物联合 ICI 与抗 VEGF 药物不联合 ICI。比较这两组之间心血管事件的总发生率，估计相应的比值比。该分析提示ICI 可能会增加抗 VEGF 治疗相关的心血管毒性风险。需要进一步研究，包括真实世界研究。
