Introduction: Immunotherapy represents a key pillar of cancer treatments, with high response rates and long survival. Its use is increasing, mainly at the expense of the geriatric population due to the ageing of this population. However, despite its benefit, its safety in certain areas such as cardiotoxicity is largely unknown. The aim of this study is to assess the safety of immunotherapy in elderly patients using real-world data. Methods: This is an ambispective study of patients ≥ 70 years old with solid tumours who were treated with immunotherapy at the University Hospital of Salamanca. Cardiotoxicity was assessed using the CTCAEv5.0 criteria. Results: In total, 195 patients were included (76.9% male and 23.1% female), with a mean age of 75 years [70–93]. The percentage of patients with cardiotoxicity was 1.54%; 1.35% of patients with previous heart disease were diagnosed with cardiotoxicity, and 1.65% of those without previous heart disease were diagnosed with cardiotoxicity. The median time from the initiation of treatment until the cardiac event was 45 days [14–96]. The most frequent toxicity was myocarditis in 66.7% of patients, followed by arrhythmias in 33.3% of patients. Conclusions: Immunotherapy is shown to be a safe treatment in elderly cancer patients in terms of cardiotoxicity. The event rate shows no difference between patients with or without cardiac comorbidity.
引言：免疫疗法已成为癌症治疗的关键支柱，其响应率高且能带来长期生存获益。随着人口老龄化加剧，该疗法在老年人群中的应用日益广泛。然而，尽管免疫疗法疗效显著，其在心脏毒性等特定领域的安全性仍不甚明确。本研究旨在通过真实世界数据评估老年患者接受免疫治疗的安全性。方法：本研究采用双向性研究设计，纳入萨拉曼卡大学医院收治的70岁及以上接受免疫治疗的实体瘤患者。心脏毒性评估采用CTCAEv5.0标准。结果：共纳入195例患者（男性76.9%，女性23.1%），平均年龄75岁[范围70-93岁]。发生心脏毒性的患者比例为1.54%；其中既往有心脏病史者心脏毒性发生率为1.35%，无心脏病史者为1.65%。从开始治疗至发生心脏事件的中位时间为45天[范围14-96天]。最常见的毒性反应为心肌炎（占66.7%），其次为心律失常（占33.3%）。结论：就心脏毒性而言，免疫疗法对老年癌症患者显示出良好的安全性。无论患者是否合并心脏基础疾病，其心脏事件发生率均无显著差异。
Cardiotoxicity Secondary to Immune Checkpoint Inhibitors in the Elderly: Safety in Real-World Data
肿瘤(癌症)患者之家