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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.

DOI:10.7759/cureus.57244
PMID:38686233
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11056906/
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/7bc1/11056906/9e2ddb2b762d/cureus-0016-00000057244-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/24748ee2159e/cureus-0016-00000057244-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/9b880eb09a3f/cureus-0016-00000057244-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/020038be7dfa/cureus-0016-00000057244-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/ebe883d9632d/cureus-0016-00000057244-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/9e2ddb2b762d/cureus-0016-00000057244-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/24748ee2159e/cureus-0016-00000057244-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/9b880eb09a3f/cureus-0016-00000057244-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/020038be7dfa/cureus-0016-00000057244-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/ebe883d9632d/cureus-0016-00000057244-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bc1/11056906/9e2ddb2b762d/cureus-0016-00000057244-i05.jpg

相似文献

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Cardiac Challenges in Immune Checkpoint Therapy: Complete Heart Block With Pembrolizumab.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
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Case of pembrolizumab-induced myocarditis presenting as torsades de pointes with safe re-challenge.帕博利珠单抗诱发的心肌炎表现为尖端扭转型室速且成功再次激发的病例。
J Oncol Pharm Pract. 2020 Sep;26(6):1544-1548. doi: 10.1177/1078155220904152. Epub 2020 Feb 23.

本文引用的文献

1
Cardiotoxicity risk factors with immune checkpoint inhibitors.免疫检查点抑制剂的心脏毒性风险因素。
Cardiooncology. 2022 Mar 11;8(1):3. doi: 10.1186/s40959-022-00130-5.
2
Immunotherapy-associated complete heart block in a patient with NSCLC: A case report and literature review.一名非小细胞肺癌患者免疫治疗相关的完全性心脏传导阻滞：病例报告及文献综述
Respir Med Case Rep. 2021 Mar 18;33:101390. doi: 10.1016/j.rmcr.2021.101390. eCollection 2021.
3
Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial.
派姆单抗联合阿昔替尼对比舒尼替尼作为晚期肾细胞癌的一线治疗（KEYNOTE-426）：一项随机、开放标签、III 期试验的延长随访。
Lancet Oncol. 2020 Dec;21(12):1563-1573. doi: 10.1016/S1470-2045(20)30436-8. Epub 2020 Oct 23.
4
A case of sustained ventricular tachycardia due to pembrolizumab.一例因帕博利珠单抗导致的持续性室性心动过速病例。
HeartRhythm Case Rep. 2019 Aug 23;5(12):570-572. doi: 10.1016/j.hrcr.2019.08.009. eCollection 2019 Dec.
5
Cardiovascular toxicities associated with immune checkpoint inhibitors: an observational, retrospective, pharmacovigilance study.免疫检查点抑制剂相关的心血管毒性：一项观察性、回顾性、药物警戒研究。
Lancet Oncol. 2018 Dec;19(12):1579-1589. doi: 10.1016/S1470-2045(18)30608-9. Epub 2018 Nov 12.