肺癌患者免疫检查点抑制剂诱导的心脏毒性:系统性审查和元分析
Naser Yamani1, Aymen Ahmed2, Gabriel Ruiz3
1Division of Cardiology, Banner University Medical Center, University of Arizona, Phoenix, AZ, USA. naser.yamani2@bannerhealth.com.
Cardio-oncology (London, England)
|June 17, 2024
概括
单一免疫检查点抑制剂 (ICI) 或ICI与化疗相结合,会增加肺癌患者心脏毒性风险. 与单次ICI使用相比,双重免疫疗法没有显示心脏事件的显著增加.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫检查点抑制剂 (ICI) 用于治疗肺癌.
- ICI可能会导致心脏毒性事件.
- 在肺癌患者中ICI的心脏毒性需要评估.
研究的目的:
- 在肺癌患者中进行评估ICI相关心脏毒性的元分析.
- 为了比较单 ICI,双 ICI 和 ICI 加上化疗与单独化疗的心脏毒性风险.
主要方法:
- 在四个数据库中进行了全面的文献搜索,截至2023年5月.
- 包括随机对照试验 (RCT),评估ICI治疗的肺癌患者的心脏结果.
- 风险比率 (RR) 和95%置信区间 (CI) 使用随机效应模型进行了聚合;使用GRADE方法评估证据质量.
主要成果:
- 对30项研究 (16,331名患者) 的分析显示,单次ICI或ICI加化疗与单次化疗相比显著增加了心脏不良事件 (RR:分别为2.15和1.38).
- 双重ICI使用与单次ICI相比,心脏毒性风险没有显著差异 (RR:0.48).
- 在ICI使用和心力衰竭或心律失常之间没有发现显著的关联.
结论:
- 单次ICI或组合ICI加化疗显著增加肺癌患者心脏毒性风险.
- 与单次ICI相比,双重免疫疗法不会显著增加心脏毒性风险.
- 这些发现凸显了接受免疫治疗的肺癌患者心脏健康监测的重要性.
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