肿瘤患者免疫检查点抑制剂心脏毒性发生率的回顾性队列研究。

IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Chin-Chin Ho, Shang-Liang Wu, Han-Yi Tsai, Yu-Wen Hu, Yuh-Lih Chang
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引用次数: 4

摘要

背景:本研究调查了使用免疫检查点抑制剂(ICIs)和其他抗癌药物治疗的癌症患者的心脏毒性发生率。方法:采用台北退伍军人总医院的医疗记录和癌症登记记录,以回顾性医院为基础的队列研究。我们招募了2011年至2017年期间被诊断为癌症的患者,这些患者年龄超过20岁,接受过ICI治疗,包括派姆单抗、纳武单抗、阿特唑单抗和伊匹单抗。心肌炎、心包炎、心律失常、心力衰竭和Takotsubo综合征诊断为心脏毒性。结果:我们确定了407例有资格参加本研究的患者。我们将三个治疗组定义为:ICI治疗、ICI联合化疗、ICI联合靶向治疗。以ICI治疗为参照组,与ICI联合化疗组(校正风险比为2.1,95%可信区间为0.2 ~ 21.1,p = 0.528)或ICI联合靶向治疗组(校正风险比为1.2,95%可信区间为0.1 ~ 9.2,p = 0.883)相比,心脏毒性风险无显著升高。心脏毒性总发生率为3.6 / 100人-年,平均发病时间为1.0±1.3年(中位数:0.5年;范围:0.1-4.7年)18例心脏毒性患者。结论:ci相关心脏毒性发生率较低。ICI联合化疗或靶向治疗可能不会显著增加癌症患者心脏毒性的风险。然而,建议在接受高危心脏毒性药物治疗的患者要小心,以避免与药物相关的心脏毒性与ICI联合治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A retrospective cohort study on the cardiotoxicity incidence rates of immune checkpoint inhibitors for oncology patients.

Background: This present study investigated the incidence rates of cardiotoxicity among cancer patients treated with immune checkpoint inhibitors (ICIs) plus other anticancer drugs.

Methods: This was a retrospective hospital-based cohort study using the medical records and the Cancer Registry records from the Taipei Veterans General Hospital. We enrolled patients diagnosed with cancer between 2011 and 2017, who were over 20 years old and had received ICI therapy, including pembrolizumab, nivolumab, atezolizumab, and ipilimumab. Cardiotoxicity was defined by the diagnosis of myocarditis, pericarditis, arrhythmia, heart failure, and Takotsubo syndrome.

Results: We identified 407 patients who were eligible to participate in this study. We defined the three treatment groups as follows: ICI therapy, ICI combined with chemotherapy, and ICI combined with targeted therapy. Using ICI therapy as a reference group, the cardiotoxicity risk was not significantly higher compared to the ICI combined with chemotherapy group (adjusted hazard ratio 2.1, 95% confidence interval 0.2-21.1, p = 0.528] or to the ICI combined with targeted therapy group (adjusted hazard ratio 1.2, 95% confidence interval 0.1-9.2, p = 0.883). The total incidence rate of cardiotoxicity was 3.6 of 100 person-years, indicating an average incidence time of 1.0 ± 1.3 years (median: 0.5 years; range: 0.1-4.7 years) for 18 cardiotoxicity patients.

Conclusion: The incidence rate of ICI-related cardiotoxicity is low. Combination of ICI with either chemotherapy or targeted therapy might not significantly increase the risk of cardiotoxicities among cancer patients. Nevertheless, it is recommend being careful in patients treated high-risk cardiotoxicity medications to avoid drug-related cardiotoxicity with a combination of ICI therapy.

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来源期刊
Journal of the Chinese Medical Association
Journal of the Chinese Medical Association MEDICINE, GENERAL & INTERNAL-
CiteScore
6.20
自引率
13.30%
发文量
320
审稿时长
15.5 weeks
期刊介绍: Journal of the Chinese Medical Association, previously known as the Chinese Medical Journal (Taipei), has a long history of publishing scientific papers and has continuously made substantial contribution in the understanding and progress of a broad range of biomedical sciences. It is published monthly by Wolters Kluwer Health and indexed in Science Citation Index Expanded (SCIE), MEDLINE®, Index Medicus, EMBASE, CAB Abstracts, Sociedad Iberoamericana de Informacion Cientifica (SIIC) Data Bases, ScienceDirect, Scopus and Global Health. JCMA is the official and open access journal of the Chinese Medical Association, Taipei, Taiwan, Republic of China and is an international forum for scholarly reports in medicine, surgery, dentistry and basic research in biomedical science. As a vehicle of communication and education among physicians and scientists, the journal is open to the use of diverse methodological approaches. Reports of professional practice will need to demonstrate academic robustness and scientific rigor. Outstanding scholars are invited to give their update reviews on the perspectives of the evidence-based science in the related research field. Article types accepted include review articles, original articles, case reports, brief communications and letters to the editor
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