Panuccio Giuseppe, Correale Pierpaolo, d'Apolito Maria, Mutti Luciano, Giannicola Rocco, Pirtoli Luigi, Giordano Antonio, Labate Demetrio, Macheda Sebastiano, Carabetta Nicole, Abdelwahed Youssef S, Landmesser Ulf, Tassone Pierfrancesco, Tagliaferri Pierosandro, De Rosa Salvatore, Torella Daniele
Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité Berlin, 12200, Berlin, Germany.
Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy.
Basic Res Cardiol. 2025 Feb;120(1):153-169. doi: 10.1007/s00395-024-01077-7. Epub 2024 Sep 3.
Immunotherapy represents an emergent and heterogeneous group of anticancer treatments harnessing the human immune-surveillance system, including immune-checkpoint inhibitor monoclonal antibodies (mAbs), Chimeric Antigen Receptor T Cells (CAR-T) therapy, cancer vaccines and lymphocyte activation gene-3 (LAG-3) therapy. While remarkably effective against several malignancies, these therapies, often in combination with other cancer treatments, have showed unforeseen toxicity, including cardiovascular complications. The occurrence of immuno-mediated adverse (irAEs) events has been progressively reported in the last 10 years. These irAEs present an extended range of severity, from self-limiting to life-threatening conditions. Although recent guidelines in CardioOncology have provided important evidence in managing cancer treatments, they often encompass general approaches. However, a specific focus is required due to the particular etiology, unique risk factors, and associated side effects of immunotherapy. This review aims to deepen the understanding of the prevalence and nature of cardiovascular issues in patients undergoing immunotherapy, offering insights into strategies for risk stratification and management.
免疫疗法是利用人体免疫监测系统的一组新兴且多样化的抗癌治疗方法，包括免疫检查点抑制剂单克隆抗体（mAb）、嵌合抗原受体T细胞（CAR-T）疗法、癌症疫苗和淋巴细胞激活基因-3（LAG-3）疗法。虽然这些疗法对几种恶性肿瘤非常有效，但通常与其他癌症治疗方法联合使用时，已显示出不可预见的毒性，包括心血管并发症。在过去10年中，免疫介导的不良（irAE）事件的发生已逐渐被报道。这些irAE的严重程度范围广泛，从自限性到危及生命的情况。尽管最近的心脏肿瘤学指南在管理癌症治疗方面提供了重要证据，但它们通常涵盖一般方法。然而，由于免疫疗法的特殊病因、独特的风险因素和相关的副作用，需要有针对性的关注。本综述旨在加深对接受免疫疗法患者心血管问题的患病率和性质的理解，为风险分层和管理策略提供见解。
