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癌症免疫治疗中的心脏毒性:系统性审查和全球元分析
Fanlin Zhou1, Guangyue Liu2, Shunhong Zhang3
1West China School of Medicine, Sichuan University, Chengdu, China.
Journal of translational medicine
|July 2, 2025
概括
使用免疫检查点抑制剂 (ICI) 的癌症免疫疗法增加了心脏毒性风险,包括心肌炎和心律失常. 这一系统性审查强调了需要仔细监测ICI治疗患者心脏不良事件的必要性.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
背景情况:
- 癌症免疫疗法,特别是免疫检查点抑制剂 (ICI),改善了患者的治疗结果.
- 然而,ICI与潜在的致命心脏风险有关,需要彻底调查.
研究的目的:
- 在患有固体瘤的患者中系统评估与免疫检查点抑制剂 (ICI) 相关的心脏毒性.
- 与安慰剂相比,在接受ICI的患者中量化心脏不良事件的风险.
主要方法:
- 对随机对照试验 (RCT) 进行了系统审查和元分析,遵循PRISMA指南.
- 包括RCT在实体瘤患者的ICI治疗与安慰剂进行了比较,报告了不良事件.
- 数据使用随机效应模型进行聚合,以确定心脏毒性的相对风险 (RR).
主要成果:
- 分析了101个RCT,其中包括58,698名患者.
- 使用ICI与显著增加所有级心脏毒性风险相关 (RR=1.31,P<0.001).
- 心肌炎 (RR=1.79,P=0.018) 和心律失常 (RR=1.22,P=0.016) 的特定风险也在ICI治疗中增加.
结论:
- 免疫检查点抑制剂 (ICI),作为单疗法或组合疗法,增加心脏毒性风险,包括心肌炎和心律失常.
- 在癌症免疫疗法期间,对ICI诱导的心脏毒性的提高警至关重要.
- 在接受ICI治疗的患者中,应特别注意对心肌炎和心律失常的监测.
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