免疫检查点抑制剂相关心肌炎:风险,诊断和临床影响
Alfredo Mauriello1, Adriana Correra2, Anna Chiara Maratea3
1S.C. Cardiology, Institute National Cancer, IRCCS, Foundation "G. Pascale", Via M. Semmola 52, 80131 Naples, Italy.
Journal of clinical medicine
|January 28, 2026
概括
免疫检查点抑制剂 (ICI) 相关心肌炎是一种罕见但致命的心脏事件. 早期诊断和积极的多学科管理,包括皮质类固醇和其他免疫抑制剂,对于改善患者的治疗结果至关重要.
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:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗,但可能导致与免疫相关的不良事件 (irAEs).
- 与ICI相关的心肌炎 (ICI-M) 是一种严重的,可能致命的IRAE,死亡率高 (27-50%).
研究的目的:
- 审查ICI诱导心肌炎的发病,流行病学,临床表现,诊断和管理.
- 突出新兴生物标志物和ICI-M的新型免疫抑制疗法.
主要方法:
- 对ICI-M现有文献进行叙述性审查.
- 病理发现,诊断方法和治疗策略的总结.
- 讨论新出现的诊断和治疗方式.
主要成果:
- ICI-M通常在治疗65天内出现,特别是在ICI联合治疗中.
- 病理学显示肌细胞亡和T细胞透,经常与肌肉炎同时发生.
- 管理涉及ICI停止,高剂量的皮质类固醇,第二线选择包括MMF,IVIG,阿巴塔塞普特和鲁克索利提尼布用于耐火病例.
结论:
- ICI-M是一种罕见但危及生命的心脏并发症,需要高度临床怀疑和及时诊断.
- 有效的管理需要采取积极的,多学科的方法来平衡治疗毒性和瘤结果.
- 新兴的生物标志物和先进的技术为早期检测和风险分层提供了潜力.
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