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与肿瘤免疫治疗和生物制剂相关的心脏毒性

英文原题:Cardiac Toxicity Associated with Cancer Immunotherapy and Biological Drugs.

查看英文原题

Cardiac Toxicity Associated with Cancer Immunotherapy and Biological Drugs.

PubMed 2021/09/25(内容时间) Cancers (Basel) Q2 · IF 4.8(JCR 2025)

研究概要

肿瘤免疫治疗对改善肿瘤患者的预后有显著贡献。

中文摘要

癌症免疫疗法显著改善了癌症患者的预后。免疫疗法包括人表皮生长因子受体2(HER2)靶向治疗、免疫检查点抑制剂(ICI)和嵌合抗原受体修饰T细胞(CAR-T);这些疗法共同利用免疫系统的能力杀伤癌细胞。曲妥珠单抗是一种抗HER2单克隆抗体,可阻断HER2介导的信号传导,主要用于HER2阳性癌症,如乳腺癌、结直肠癌、胆道癌和非小细胞肺癌。免疫检查点抑制剂通过抑制CTLA-4或PD-1与PD-L1结合,使T细胞能够杀伤癌细胞;可用于黑色素瘤、非小细胞肺癌、尿路上皮癌以及头颈癌。T细胞转移疗法主要有两种:TIL(肿瘤浸润淋巴细胞)疗法和CAR-T细胞疗法,后者主要用于B细胞淋巴瘤、白血病和套细胞淋巴瘤。HER2靶向治疗(主要是曲妥珠单抗)可能导致左心室功能障碍,通常可逆且极少危及生命。PD/PDL-1抑制剂可能引发心肌炎,虽罕见,但可能暴发且死亡率高。CAR-T治疗也与多种心脏毒性有关,主要发生于全身性不良反应背景下的细胞因子释放综合征。

展开英文摘要原文

Cancer immunotherapy significantly contributed to an improvement in the prognosis of cancer patients. Immunotherapy, including human epidermal growth factor receptor 2 (HER2)-targeted therapies, immune checkpoint inhibitors (ICI), and chimeric antigen receptor-modified T (CAR-T), share the characteristic to exploit the capabilities of the immune system to kill cancerous cells. Trastuzumab is a monoclonal antibody against HER2 that prevents HER2-mediated signaling; it is administered mainly in HER2-positive cancers, such as breast, colorectal, biliary tract, and non-small-cell lung cancers. Immune checkpoint inhibitors (ICI) inhibit the binding of CTLA-4 or PD-1 to PDL-1, allowing T cells to kill cancerous cells. ICI can be used in melanomas, non-small-cell lung cancer, urothelial, and head and neck cancer. There are two main types of T-cell transfer therapy: tumor-infiltrating lymphocytes (or TIL) therapy and chimeric antigen receptor-modified T (CAR-T) cell therapy, mainly applied for B-cell lymphoma and leukemia and mantle-cell lymphoma. HER2-targeted therapies, mainly trastuzumab, are associated with left ventricular dysfunction, usually reversible and rarely life-threatening. PD/PDL-1 inhibitors can cause myocarditis, rare but potentially fulminant and associated with a high fatality rate. CAR-T therapy is associated with several cardiac toxic effects, mainly in the context of a systemic adverse effect, the cytokines release syndrome.

论文信息

作者
Montisci A、Vietri MT、Palmieri V、Sala S、Donatelli F、Napoli C
第一作者单位
Division of Cardiothoracic Intensive Care, ASST Spedali Civili, 25123 Brescia, Italy.Italy
通讯作者单位
Clinical Department of Internal Medicine and Specialistics, University Department of Advanced Clinical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 81100 Naples, Italy.Italy
文献类型
综述
期刊
Cancers2021 Sep 25
原文标识
PubMed 34638281 · DOI 10.3390/cancers13194797