预先存在的心血管疾病与免疫检查点抑制剂治疗患者的存活率之间的关联
Aditya Mahadevan1, Aidan Vosooghi2, Jagmeet Arora3
1Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Cancer medicine
|April 29, 2025
概括
患有先前存在的心血管疾病 (CVD) 的患者在接受免疫检查点抑制剂 (ICI) 治疗时面临死亡风险增加. 诸如心力衰竭和心房这样的疾病显著影响这些患者的生存结果.
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:
- 预先存在的心血管疾病 (CVD) 对接受免疫检查点抑制剂 (ICI) 治疗的患者的生存的影响仍然不清楚.
- 了解这种关系对于优化患者护理和预测治疗结果至关重要.
研究的目的:
- 研究在接受免疫检查点抑制剂 (ICI) 治疗的患者的基线心血管疾病 (CVD) 和死亡率之间的关联.
- 分析特定心血管疾病对接受ICI单疗法或组合治疗的患者生存的影响.
主要方法:
- 利用了TrinetX全球数据库,涵盖了超过1亿2千万名患者.
- 在开始ICI治疗之前,已经确定了27,820名患有心血管疾病 (CVD) 的患者.
- 将这些患者与没有先前存在心血管疾病的相同数量的对照匹配.
主要成果:
- 系统性心力衰竭与死亡率的相关性最高 (HR: 1.38,95% CI: 1.29-1.48).
- 扩张性心力衰竭 (HR: 1.34,95% CI: 1.27-1.42) 和心房动/动 (HR: 1.24,95% CI: 1.19-1.29) 也与增加的死亡率有显著联系.
- 这些关联在接受ICI单疗的患者中观察到.
结论:
- 基线心血管疾病 (CVD) 在接受免疫检查点抑制剂 (ICI) 治疗的患者中显著影响死亡风险.
- 将心血管疾病评估纳入临床试验可以改善风险分层并指导预治疗策略.
- 未来的研究应该专注于为高风险患者制定有针对性的监测和优化计划.
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