肿瘤细胞治疗研究
英文原题：Cardiotoxicity of T-Cell Antineoplastic Therapies: JACC: CardioOncology Primer.
Cardiotoxicity of T-Cell Antineoplastic Therapies: JACC: CardioOncology Primer.
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回顾性研究显示，在接受 CAR-T 细胞治疗后发生高级别 CRS 的患者中，有 10% 至 20% 出现心血管并发症，可包括心肌病、心力衰竭、心律失常和心肌梗死。
T细胞疗法，如嵌合抗原受体（CAR）T细胞、双特异性T细胞衔接器（BiTE）和TIL（肿瘤浸润淋巴细胞）疗法，可攻击携带特定肿瘤抗原的癌细胞。然而，这些疗法激活免疫反应可能导致全身性炎症反应，称为细胞因子释放综合征（CRS），进而引发不良事件，包括心脏毒性。回顾性研究表明，在接受CAR-T 细胞治疗后发生高级别CRS的患者中，10%至20%会出现心血管并发症，可能包括心肌病、心力衰竭、心律失常和心肌梗死。虽然BiTE和TIL疗法的心脏毒性报道较少，但尚未进行系统性的心脏毒性监测。接受T细胞疗法的患者应筛查可能无法承受CRS所致血流动力学扰动的心血管状况。CRS的一般管理，包括对高级别CRS使用白细胞介素-6拮抗剂托珠单抗，用于减轻心脏毒性风险。
T-cell therapies, such as chimeric antigen receptor (CAR) T-cell, bispecific T-cell engager (BiTE) and tumor-infiltrating lymphocyte (TIL) therapies, fight cancer cells harboring specific tumor antigens. However, activation of the immune response by these therapies can lead to a systemic inflammatory response, termed cytokine release syndrome (CRS), that can result in adverse events, including cardiotoxicity. Retrospective studies have shown that cardiovascular complications occur in 10% to 20% of patients who develop high-grade CRS after CAR T-cell therapy and can include cardiomyopathy, heart failure, arrhythmias, and myocardial infarction. While cardiotoxicities have been less commonly reported with BiTE and TIL therapies, systematic surveillance for cardiotoxicity has not been performed. Patients undergoing T-cell therapies should be screened for cardiovascular conditions that may not be able to withstand the hemodynamic perturbations imposed by CRS. Generalized management of CRS, including the use of the interleukin-6 antagonist, tocilizumab, for high-grade CRS, is used to mitigate the risk of cardiotoxicity.
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