Radiation-induced coronary artery disease during immune checkpoint inhibitor therapy: a case report.

IF 2.7 4区 医学 Q3 IMMUNOLOGY Immunotherapy Pub Date : 2024-04-01 Epub Date: 2024-02-05 DOI:10.2217/imt-2023-0084
Xiajing Qian, Kequan Ding, Yi Lu
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Abstract

Radiation-induced coronary artery disease (RICAD) poses a serious concern for cancer patients post radiotherapy, typically emerging after over a decade. Immune checkpoint inhibitors (ICIs), known for cardiotoxicity, are increasingly recognized for causing cardiovascular complications. Here we report the case of a 63-year-old man with metastatic lung cancer who developed coronary artery disease during his third-line therapy with an ICI (nivolumab) and an antiangiogenic agent (bevacizumab), 3 years post chest radiotherapy. Angiography revealed relatively isolated stenosis in the left main coronary artery ostium, consistent with the radiotherapy site, with no other risk factors, suggesting RICAD. The potential for ICIs to accelerate RICAD development should be considered and necessitates careful surveillance in patients receiving both radiotherapy and ICIs.

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免疫检查点抑制剂治疗期间辐射诱发的冠状动脉疾病:病例报告。
放疗诱发的冠状动脉疾病(RICAD)是放疗后癌症患者的一个严重问题,通常在十多年后才会出现。以心脏毒性著称的免疫检查点抑制剂(ICIs)越来越被认为会引起心血管并发症。在此,我们报告了一例 63 岁的转移性肺癌患者,他在接受 ICI(nivolumab)和抗血管生成剂(贝伐单抗)的三线治疗期间,在胸部放疗后 3 年出现了冠状动脉疾病。血管造影显示左冠状动脉主干骨膜有相对孤立的狭窄,与放疗部位一致,没有其他危险因素,这表明存在 RICAD。应考虑到 ICIs 有可能加速 RICAD 的发展,因此有必要对同时接受放疗和 ICIs 的患者进行仔细监测。
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来源期刊
Immunotherapy
Immunotherapy 医学-免疫学
CiteScore
5.00
自引率
3.60%
发文量
113
审稿时长
6-12 weeks
期刊介绍: Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.
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