Cardiovascular toxicities associated with immune checkpoint inhibitors

被引：362

作者：

Hu, Jiun-Ruey ^{[1
]}

Florido, Roberta ^{[2
]}

Lipson, Evan J. ^{[3
,4
]}

Naidoo, Jarushka ^{[3
,4
]}

Ardehali, Reza ^{[5
]}

Tocchetti, Carlo G. ^{[6
]}

Lyon, Alexander R. ^{[7
,8
]}

Padera, Robert F. ^{[9
]}

Johnson, Douglas B. ^{[10
]}

Moslehi, Javid ^{[1
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Cardiooncol Program, Div Cardiol, 2220 Pierce Ave, Nashville, TN 37232 USA

[2] Johns Hopkins Univ, Sch Med, Div Cardiol, 600 N Wolfe St, Baltimore, MD 21287 USA

[3] Johns Hopkins Univ, Sch Med, Sidney Kimmel Comprehens Canc Ctr, Dept Oncol, 1550 Orleans St, Baltimore, MD 21287 USA

[4] Johns Hopkins Univ, Sch Med, Bloomberg Kimmel Inst Canc Immunotherapy, 1550 Orleans St, Baltimore, MD 21287 USA

[5] Univ Calif Los Angeles, David Geffen Sch Med, Div Cardiol, 675 Charles E Young Dr S, Los Angeles, CA 90095 USA

[6] Univ Naples Federico II, Interdept Ctr Clin & Translat Res CIRCET, Dept Translat Med Sci, Via Pansini 5, I-80131 Naples, NA, Italy

[7] Royal Brompton Hosp, Cardiooncol Serv, Dovehouse St, London SW3 6LY, England

[8] Imperial Coll London, Natl Heart & Lung Inst, Sydney St, London SW3 6NP, England

[9] Brigham & Womens Hosp, Dept Pathol, 75 Francis St, Boston, MA 02115 USA

[10] Vanderbilt Univ, Med Ctr, Div Hematol Oncol, 2220 Pierce Ave, Nashville, TN 37232 USA

来源：

CARDIOVASCULAR RESEARCH | 2019年 / 115卷 / 05期

关键词：

Cardio-oncology; Immune checkpoint inhibitors; Myocarditis; Vasculitis; Pericarditis; Cardiovascular toxicity; DILATED CARDIOMYOPATHY; FULMINANT MYOCARDITIS; PERICARDIAL-EFFUSION; EUROPEAN-SOCIETY; CELL ARTERITIS; MANAGEMENT; NIVOLUMAB; IPILIMUMAB; DISEASE; CTLA-4;

D O I：

10.1093/cvr/cvz026

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Cardiovascular toxicities associated with immune checkpoint inhibitors (ICIs) have been reported in case series but have been underappreciated due to their recent emergence, difficulties in diagnosis and non-specific clinical manifestations. ICIs are antibodies that block negative regulators of the T cell immune response, including cytotoxic T lymphocyte-associated protein-4 (CTLA-4), programmed cell death protein-1 (PD-1), and PD-1 ligand (PD-L1). While ICIs have introduced a significant mortality benefit in several cancer types, the augmented immune response has led to a range of immune-related toxicities, including cardiovascular toxicity. ICI-associated myocarditis often presents with arrhythmias, may co-exist with myositis and myasthenia gravis, can be severe, and portends a poor prognosis. In addition, pericardial disease, vasculitis, including temporal arteritis, and non-inflammatory heart failure, have been recently described as immune-related toxicities from ICI. This narrative review describes the epidemiology, diagnosis, pathophysiology, and treatment of cardiovascular toxicities of ICI therapy, highlighting recent developments in the field in the past year.

引用

页码：854 / 868

页数：15

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