Division of Metabolic and Cardiovascular Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, United States.
Am J Physiol Heart Circ Physiol. 2023 Oct 1;325(4):H751-H767. doi: 10.1152/ajpheart.00378.2023. Epub 2023 Aug 18.
The use of immunotherapies like pembrolizumab (PEM) is increasingly common for the management of numerous cancer types. The use of PEM to bolster T-cell response against tumor growth is well documented. However, the interactions PEM has on other immune cells to facilitate tumor regression and clearance is unknown and warrants further investigation. In this review, we present literature findings that have reported the interactions of PEM in stimulating innate and adaptive immune cells, which enhance cytotoxic phenotypes. This triggers secretion of cytokines and chemokines, which have both beneficial and detrimental effects. We also describe how this leads to the development of rare but underreported occurrence of PEM-induced immune-related cardiovascular complications that arise suddenly and progress rapidly to debilitating and fatal consequences. This review encourages further research and investigation of PEM-induced cardiovascular complications and other immune cell interactions in patients with cancer. As PEM therapy in treating cancer types is expanding, we expect that this review will inform health care professionals of diverse specializations of medicine like dermatology (melanoma skin cancers), ophthalmology (eye cancers), and pathology (hematological malignancies) about PEM-induced cardiac complications.
免疫疗法的应用越来越普遍，如 pembrolizumab（PEM），用于治疗多种癌症类型。PEM 被广泛用于增强 T 细胞对肿瘤生长的反应。然而，PEM 对其他免疫细胞的作用，以促进肿瘤消退和清除尚不清楚，值得进一步研究。在这篇综述中，我们介绍了文献中报道的 PEM 刺激先天和适应性免疫细胞的相互作用，这些相互作用增强了细胞毒性表型。这会触发细胞因子和趋化因子的分泌，这些因子既有有益的，也有有害的作用。我们还描述了这如何导致 PEM 诱导的免疫相关心血管并发症的罕见但报告不足的发生，这些并发症突然发生并迅速发展为使人衰弱和致命的后果。这篇综述鼓励进一步研究和调查 PEM 诱导的心血管并发症和癌症患者中其他免疫细胞的相互作用。随着 PEM 疗法在治疗癌症类型方面的扩展，我们预计这篇综述将使皮肤科（黑色素瘤皮肤癌）、眼科（眼癌）和病理学（血液恶性肿瘤）等医学领域的各种专业的医疗保健专业人员了解 PEM 诱导的心脏并发症。
