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免疫检查点疗法中的心脏挑战:派姆单抗导致的完全性心脏传导阻滞

Cardiac Challenges in Immune Checkpoint Therapy: Complete Heart Block With Pembrolizumab.

作者信息

Sabanci Rand, Saeed Moiz, Watat Kevin, Kim Andrew G, Shaban Dina, Nader Georgette, Ghnaima Harith, Wilcox Matthew, Ali-Ahmed Fatima

机构信息

Internal Medicine, Michigan State University, East Lansing, USA.

Internal Medicine, Michigan State University College of Human Medicine, East Lansing, USA.

出版信息

Cureus. 2024 Mar 30;16(3):e57244. doi: 10.7759/cureus.57244. eCollection 2024 Mar.

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, yet they come with a spectrum of immune-related adverse events, including cardiac complications. We present the case of a 72-year-old male with metastatic renal cell carcinoma who developed complete heart block and ventricular arrhythmias following pembrolizumab therapy. Despite no evidence of myocarditis, the patient's condition rapidly deteriorated, ultimately resulting in his demise. This case underscores the critical need for vigilance in recognizing and managing potential cardiotoxicity associated with ICIs. Additionally, it highlights the importance of multidisciplinary collaboration in optimizing diagnostic and therapeutic strategies for patients undergoing immune checkpoint inhibitor therapy.

摘要

免疫检查点抑制剂(ICIs)彻底改变了癌症治疗方式,但它们会引发一系列免疫相关不良事件,包括心脏并发症。我们报告一例72岁转移性肾细胞癌男性患者,其在接受派姆单抗治疗后出现完全性心脏传导阻滞和室性心律失常。尽管没有心肌炎的证据,但患者病情迅速恶化,最终死亡。该病例强调了在识别和管理与ICIs相关的潜在心脏毒性方面保持警惕的迫切需要。此外,它突出了多学科协作在优化接受免疫检查点抑制剂治疗患者的诊断和治疗策略中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/24748ee2159e/cureus-0016-00000057244-i01.jpg

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