免疫检查点抑制剂相关心肌炎:文献综述
Rohail Gul1, Muhammad Shehryar2, Anber Mahboob3
1Internal Medicine, Shifa Tameer-E-Millat University Shifa College of Medicine, Islamabad, PAK.
Cureus
|February 26, 2024
概括
免疫检查点抑制剂 (ICI) 治疗癌症,但可能导致心肌炎,严重的心脏病. 管理往往涉及类固醇,而重新挑战决策需要专家咨询,因为数据有限.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
背景情况:
- 免疫检查点抑制剂 (ICI) 在瘤学中越来越多地用于癌症治疗.
- ICI疗法激活免疫系统以消除癌细胞,但可能导致与免疫相关的不良事件 (irAEs).
- 肌心炎是一种与ICI治疗相关的潜在致命的irAE.
研究的目的:
- 进行与免疫检查点抑制剂 (ICI) 使用有关的心肌炎的叙事审查.
- 探索ICI诱导心肌炎的机制,管理和再挑战策略.
主要方法:
- 一个对研究的叙述性回顾.
- 在PubMed,Cochrane和美国临床瘤学会 (ASCO) 数据库中进行的搜索.
- 专注于关于ICI使用的不良影响,特别是心肌炎的原始出版物.
主要成果:
- 使用ICI进行的癌症免疫疗法与许多心肌炎病例有关.
- 心肌炎的主要机制是免疫系统的交叉反应,可能是通过分子模仿.
- 管理主要基于病例报告和系列,通常从类固醇开始;重新挑战数据有限.
结论:
- 尽管存在心肌炎的风险,但ICI单疗的益处往往超过风险.
- 在心肌炎后,关于ICI重新挑战的决定需要由多学科团队进行个性化评估.
- 迫切需要更多关于ICI诱导心肌炎和重新挑战安全性的数据和前性研究.
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