Toribio-García Irene, Olivares-Hernández Alejandro, Miramontes-González José Pablo, Domínguez Luis Posado, Martín García Ana, Eiros Bachiller Rocío, Figuero-Pérez Luis, Garijo Martínez María, Roldán Ruiz Jonnathan, Bellido Hernández Lorena, Fonseca-Sánchez Emilio, Luis Sánchez Pedro, Del Barco-Morillo Edel
Department of Cardiology, University Hospital of Leon, 24008 León, Spain.
Department of Medical Oncology, University Hospital of Salamanca, 37007 Salamanca, Spain.
Cancers (Basel). 2023 Aug 28;15(17):4293. doi: 10.3390/cancers15174293.
Immunotherapy represents a key pillar of cancer treatments, with high response rates and long survival. Its use is increasing, mainly at the expense of the geriatric population due to the ageing of this population. However, despite its benefit, its safety in certain areas such as cardiotoxicity is largely unknown. The aim of this study is to assess the safety of immunotherapy in elderly patients using real-world data.
This is an ambispective study of patients ≥ 70 years old with solid tumours who were treated with immunotherapy at the University Hospital of Salamanca. Cardiotoxicity was assessed using the CTCAEv5.0 criteria.
In total, 195 patients were included (76.9% male and 23.1% female), with a mean age of 75 years [70-93]. The percentage of patients with cardiotoxicity was 1.54%; 1.35% of patients with previous heart disease were diagnosed with cardiotoxicity, and 1.65% of those without previous heart disease were diagnosed with cardiotoxicity. The median time from the initiation of treatment until the cardiac event was 45 days [14-96]. The most frequent toxicity was myocarditis in 66.7% of patients, followed by arrhythmias in 33.3% of patients.
Immunotherapy is shown to be a safe treatment in elderly cancer patients in terms of cardiotoxicity. The event rate shows no difference between patients with or without cardiac comorbidity.
免疫疗法是癌症治疗的关键支柱，具有高缓解率和长生存期。其使用正在增加，主要是以老年人群体为代价，因为该群体正在老龄化。然而，尽管有其益处，但其在某些领域如心脏毒性方面的安全性在很大程度上尚不清楚。本研究的目的是使用真实世界数据评估免疫疗法在老年患者中的安全性。
这是一项对萨拉曼卡大学医院接受免疫疗法治疗的≥70岁实体瘤患者的双向研究。使用CTCAEv5.0标准评估心脏毒性。
总共纳入了195例患者（男性占76.9%，女性占23.1%），平均年龄为75岁[70 - 93岁]。心脏毒性患者的百分比为1.54%；既往有心脏病的患者中有1.35%被诊断为心脏毒性，而无既往心脏病的患者中有1.65%被诊断为心脏毒性。从开始治疗到发生心脏事件的中位时间为45天[14 - 96天]。最常见的毒性是心肌炎，占患者的66.7%，其次是心律失常，占患者的33.3%。
就心脏毒性而言，免疫疗法在老年癌症患者中被证明是一种安全的治疗方法。有或无心脏合并症的患者之间的事件发生率没有差异。
