Current understanding of the cardiotoxicity-related treatment of immune checkpoint inhibitors in breast cancer

Dai Jiajing
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Abstract

Immune Checkpoint Inhibitors (ICIs) as the most important and widely used currently, have changed the traditional approach to cancer treatment and significantly improved the prognosis of most patients with advanced malignancies. Breast cancer is the most dangerous threatening tumor to women’s health and life globally, ICIs have shed light on the treatment for refractory breast cancer subtypes, including Triple-Negative Breast Cancer (TNBC) and trastuzumab resistance of human epidermal growth factor receptor 2 positives (HER2+). However, immune-related adverse events (irAE) associated with ICIs bring many extra considerations. Among these, potential cardiotoxicity is rarely seen but with the highest fatality rate. In the present review, we introduced the ICIs approved for the treatment of breast cancer and brief guideline for clinical application. Then we briefly summarized ICIs-related cardiotoxicity in breast cancer and mechanism based on immunology and basic medical research. Furthermore, we make a brief summary of the diagnosis methods.
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目前对乳腺癌免疫检查点抑制剂心脏毒性相关治疗的了解
免疫检查点抑制剂(Immune Checkpoint Inhibitors, ICIs)作为目前最重要和应用最广泛的药物,改变了传统的癌症治疗方式,显著改善了大多数晚期恶性肿瘤患者的预后。乳腺癌是全球范围内对女性健康和生命威胁最大的肿瘤,ICIs为难治性乳腺癌亚型的治疗提供了新的线索,包括三阴性乳腺癌(TNBC)和人表皮生长因子受体2阳性(HER2+)的曲妥珠单抗耐药性。然而,与ici相关的免疫相关不良事件(irAE)带来了许多额外的考虑。其中,潜在的心脏毒性很少见到,但死亡率最高。在本文中,我们介绍了已被批准用于治疗乳腺癌的ICIs及其临床应用的简要指南。在此基础上,从免疫学和基础医学研究的角度对乳腺癌中icis相关的心脏毒性及其作用机制进行了综述。此外,我们还对诊断方法作了简要的总结。
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