免疫检查点抑制剂相关心脏毒性反应的研究进展

Research progress of immune checkpoint inhibitor-associated cardiotoxicity

恶性肿瘤的药物治疗多年来限于化疗和靶向药物治疗,疗效有限。近年来,新型免疫治疗药物—免疫检查点抑制剂(ICIs)成为恶性肿瘤治疗的重大突破,现已在多种实体肿瘤中广泛应用于临床,取得良好疗效。然而,ICIs可引发各种器官和组织的多种免疫相关不良反应(irAEs),严重irAEs如未能及时诊治将会危及患者生命。免疫相关心脏毒性是其中一种发病率低但死亡率高的类型。随着ICIs越来越多地在各医疗中心使用,免疫相关心脏毒性的病例也逐年增多,已成为临床医生必须了解和关注的问题。本综述对目前相关领域的研究和报道进行汇总分析,包括发病率、临床表现、发病危险因素、死亡率、发病机制、监测、诊断和治疗。

Anti-malignancy agents,mainly including chemotherapy and target therapy,were used for years with limited efficacy.As a new type of immunotherapeutic agent,immune checkpoint inhibitors(ICIs)have become a breakthrough in the treatment of cancer in recent years.It was extensively used in treating types of malignancies with excellent efficacy.However,ICIs can induce different immune-related adverse events(irAEs)in all kinds of organs and tissues,and the serious type of irAEs could be life-threatening.ICI-related cardiotoxicity is one type of adverse events with low morbidity and high mortality.More and more cases of ICI-related cardiotoxicity were reported with the wide application of ICIs in different medical centers globally,and physicians must pay attention to and be acquaint with the knowledge of this field.This review comprehends the research and reports about ICI-related cardiotoxicity,including morbidity and mortality,clinical manifestation,risk factors of morbidity,mechanism,surveillance,diagnosis and treatment.