免疫检查点抑制剂治疗患者中既往存在的心血管疾病与生存之间的关联。
Associations Between Pre-Existing Cardiovascular Disease and Survival in Patients on Immune Checkpoint Inhibitor Therapy.
作者信息
Mahadevan Aditya, Vosooghi Aidan, Arora Jagmeet, Jones Jeffrey, Moslehyazdi Maziar, Chow Warren A
机构信息
Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
出版信息
Cancer Med. 2025 May;14(9):e70846. doi: 10.1002/cam4.70846.
BACKGROUND
The impact of baseline cardiovascular disease (CVD) on survival in patients undergoing immune checkpoint inhibitor (ICI) therapy is not well understood. Therefore, we sought to determine the relationship between baseline CVD on mortality in patients undergoing ICI monotherapy or combination therapy.
METHODS
Using TriNetX, a global database of over 120 million patients, we identified 27,820 patients with pre-existing cardiovascular disease prior to starting ICI monotherapy and an equal number of corresponding matched controls.
RESULTS
Systolic heart failure (HR: 1.38, 95% CI: 1.29-1.48), diastolic heart failure (HR: 1.34, 95% CI: 1.27-1.42), and atrial fibrillation/flutter (HR: 1.24, 95% CI: 1.19-1.29) had the greatest associations with mortality across ICI monotherapy.
CONCLUSION
Future trials of patients initiating ICI therapy should capture these baseline values to guide risk assessment, pretreatment optimization, and surveillance strategies prior to treatment initiation.
背景
基线心血管疾病（CVD）对接受免疫检查点抑制剂（ICI）治疗的患者生存的影响尚不清楚。因此，我们试图确定基线CVD与接受ICI单药治疗或联合治疗患者死亡率之间的关系。
方法
利用TriNetX（一个拥有超过1.2亿患者的全球数据库），我们确定了27820例在开始ICI单药治疗前已有心血管疾病的患者以及数量相等的相应匹配对照。
结果
在ICI单药治疗中，收缩性心力衰竭（HR：1.38，95%CI：1.29-1.48）、舒张性心力衰竭（HR：1.34，95%CI：1.27-1.42）和心房颤动/扑动（HR：1.24，95%CI：1.19-1.29）与死亡率的关联最大。
结论
启动ICI治疗患者的未来试验应获取这些基线值，以指导治疗开始前的风险评估、预处理优化和监测策略。
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