Background/Objectives: Cancer immunotherapy has revolutionized the field of oncology by harnessing the immune system to attack cancer cells, increasing survival in a broad spectrum of malignancies. However, despite its positive therapeutic benefit, immunotherapy is also associated with a spectrum of adverse events affecting various vital organs, including the cardiovascular system.Methods: We conducted a comprehensive review of the available literature on the epidemiology, pathophysiological mechanisms, and current management approaches for cardiovascular adverse events associated with cancer immunotherapy. In addition, we evaluated emerging personalized strategies and interventions aimed at mitigating these risks and improving patient outcomes.Results: Immunotherapy is associated with a broad spectrum of potentially serious cardiovascular adverse events, including immune-mediated myocarditis, heart failure, arrhythmias, pericarditis, and accelerated atherosclerosis. Among these, immune checkpoint inhibitor-associated myocarditis is the most well characterized and potentially fatal form of cardiotoxicity, with reported mortality rates approaching 50%. Similarly, chimeric antigen receptor T-cell therapy, despite its powerful antitumor efficacy, is frequently associated with cytokine release syndrome—a profound immune activation that can lead to significant systemic and cardiovascular complications. In response to these challenges, several personalized strategies are currently under development, including artificial intelligence and machine learning approaches, genetic and transcriptomic profiling, novel biomarker discovery, and integrated risk scoring systems, all aimed at enhancing risk stratification and improving patient care.Conclusions: Cancer immunotherapy has been associated with a range of immune-related cardiac adverse events, both non-severe and severe. As such, it is critically important to adopt a personalized approach to patient management before, during, and after the administration of immunotherapy. Early recognition through heightened clinical vigilance, along with the implementation of individualized risk assessment tools, is essential for identifying patients at high risk of immunotherapy-induced cardiotoxicity. These strategies are imperative for optimizing patient outcomes and ensuring safe and effective cancer treatment.
背景/目的：癌症免疫疗法通过调动免疫系统攻击癌细胞，已在肿瘤学领域引发革命性突破，显著提高了多种恶性肿瘤患者的生存率。然而，尽管免疫疗法具有积极的治疗效果，其亦可能引发一系列累及包括心血管系统在内的多个重要器官的不良事件。 方法：我们对现有关于癌症免疫疗法相关心血管不良事件的流行病学、病理生理机制及当前管理策略的文献进行了全面综述。此外，我们评估了旨在降低这些风险并改善患者预后的新兴个性化策略与干预措施。 结果：免疫疗法与一系列潜在严重心血管不良事件相关，包括免疫介导性心肌炎、心力衰竭、心律失常、心包炎以及加速性动脉粥样硬化。其中，免疫检查点抑制剂相关心肌炎是特征最明确且可能致命的类型，据报道其死亡率接近50%。同样，嵌合抗原受体T细胞疗法尽管具有强大的抗肿瘤疗效，但常伴随细胞因子释放综合征——一种可能导致严重全身性和心血管并发症的剧烈免疫激活。为应对这些挑战，目前正在开发多种个性化策略，包括人工智能与机器学习方法、遗传与转录组学分析、新型生物标志物发现以及整合风险评分系统，均旨在加强风险分层并优化患者管理。 结论：癌症免疫疗法与一系列从非严重到严重的免疫相关心脏不良事件相关。因此，在免疫疗法实施前、中、后采取个性化的患者管理策略至关重要。通过提高临床警惕性实现早期识别，并结合个体化风险评估工具的应用，对于识别免疫疗法诱发心脏毒性高风险患者具有关键意义。这些策略对于优化患者预后、确保癌症治疗的安全性和有效性至关重要。
肿瘤(癌症)患者之家