clinvestКачественная клиническая практикаKachestvennaya Klinicheskaya Praktika = Good Clinical Practice2588-05192618-8473ООО «Издательство ОКИclinvest-477Research ArticleБЕЗОПАСНОСТЬ ЛЕКАРСТВDRUG SAFETYСердечно-сосудистые осложнения терапии ингибиторами контрольных точек иммунитетаCardiovascular complications of immune checkpoint inhibitorshttps://orcid.org/0000-0002-8576-3159КулиеваА. А.KulievаA. A.

Кулиева Айгюн Азеровна - аспирант кафедры госпитальной терапии №2 лечебного факультета

Москва

Kulieva Aygyun - graduate student of the Department of hospital therapy №2, Faculty of Medicine

Moscow

Onistella@mail.ruЕмелинаЕ. И.EmelinaE. I.

Емелина Елена Ивановна - доцент, к. м. н. кафедры госпитальной терапии №2 лечебного факультета

Москва

Emelina Elena - PhD, associate professor, Department of hospital therapy №2, Faculty of Medicine

Moscow

https://orcid.org/0000-0002-7846-1611ГендлинГ. Е.GendlinG. E.

Гендлин Геннадий Ефимович - профессор, д. м. н. кафедры госпитальной терапии №2 лечебного факультета

Москва

Gendlin Gennady - DM, professor, Department of hospital therapy №2, Faculty of Medicine

Moscow

https://orcid.org/0000-0003-1699-0881НикитинИ. Г.NikitinI. G.

Никитин Игорь Геннадиевич - профессор, д. м. н. зав. кафедрой госпитальной терапии №2 лечебного факультета

Москва

Nikitin Igor - DM, professor, Head of Department of hospital therapy №2, Faculty of Medicine

Moscow

https://orcid.org/0000-0002-6348-6867ЗыряновС. К.ZyryanovS. K.

Зырянов Сергей Кенсаринович - д. м. н., профессор, зав. кафедрой общей и клинической фармакологии, ФГАОУ ВО «Российский университет дружбы народов» (Медицинский институт); Государственное бюджетное учреждение города Москвы Городская клиническая больница № 24 Департамента здравоохранения города Москвы. SPIN-код: 2725-9981

Москва

Zyryanov Sergey - MD, professor, Head of Department of General and Clinical Pharmacology, Medical Institute of the Peoples’ Friendship University of Russia; State Budgetary Institution of the City of Moscow City Clinical Hospital No. 24 of the Moscow City Health Department Russian Federation. SPIN code: 2725-9981

Moscow

ВаренцовС. И.VarentsovS. I.

Варенцов Сергей Игоревич - врач-анестезиолог-реаниматолог, зав. отделением реанимации

Москва

 

Varentsov Sergey - anaesthesiologist-resuscitator, Head of Resuscitation Department

Moscow

ЗахароваИ. И.ZakharovaI. I.

Захарова Ирина Игоревна - врач-кардиолог, зав. отделение кардиологии

Москва

Zakharova Irina - Cardiologist, Head of Cardiology Department

Moscow

ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationФГАОУ ВО «Российский университет дружбы народов»; ГБУЗ «ГКБ №24 ДЗМ»РоссияRussian University of Nations’ Friendship; City Clinical Hospital №24Russian FederationГБУЗ «ГКБ №24 ДЗМ»РоссияCity Clinical Hospital №24Russian Federation201907042020045565Copyright © Кулиева А.А., Емелина Е.И., Гендлин Г.Е., Никитин И.Г., Зырянов С.К., Варенцов С.И., Захарова И.И., 20202020Кулиева А.А., Емелина Е.И., Гендлин Г.Е., Никитин И.Г., Зырянов С.К., Варенцов С.И., Захарова И.И.Kulievа A.A., Emelina E.I., Gendlin G.E., Nikitin I.G., Zyryanov S.K., Varentsov S.I., Zakharova I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinvest.ru/jour/article/view/477

Кардиотоксичность при лечении злокачественных новообразований остаётся актуальной проблемой. Создание высокоэффективных противоопухолевых препаратов, как правило, означает и появление новых побочных явлений. Ингибиторы контрольных точек иммунитета (ИКТИ) — это новый класс противоопухолевых лекарственных препаратов, отличный от традиционных химиотерапевтических и таргетных препаратов. Иммунотерапия с помощью ингибиторов контрольных точек иммунитета (моноклональных антител, нацеленных на цитотоксический Т-лимфоцитарный ассоциированный антиген 4 (CTLA-4), программируемую клеточную гибель 1 (PD-1) и его лиганд (PD-L1)) значительно улучшила результаты лечения злокачественных опухолей. Эти препараты, регулируя противоопухолевый иммунитет, опосредуют регрессию рака и улучшают выживаемость, но также могут вызывать широкий спектр связанных с иммунитетом нежелательных явлений. Хотя кардиотоксичность, связанная с применением ИКТИ, встречается редко, она имеет важное значение из-за высоких показателей смертности. В течение последних лет всё чаще регистрируются случаи миокардита и фатальной сердечной недостаточности у пациентов, получавших ингибиторы контрольных точек иммунитета. В данном обзоре обсуждаются изученные на сегодняшний день механизмы кардиотоксичности, способы профилактики и лечения данных нежелательных явлений. Тяжёлые сердечно-сосудистые последствия, связанные с применением ИКТИ, представляют собой важные вопросы для онкологов, кардиологов и иммунологов.

Cardiovascular toxicity of cancer therapies remains an urgent problem today. The creation of highly effect antitumor drugs also means the appearance of new adverse effects. Immune checkpoint inhibitors (ICI) is a new class of antitumor drugs that is different from traditional chemotherapeutic and targeted drugs. Immunotherapy with ICI (monoclonal antibodies targeting the cytotoxic T-lymphocyte associated antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1) or its ligand (PD-L1)) significantly improved the results of treatment of cancer therapy. These drugs regulate antitumor immunity and promote cancer regression and improve survival, but can also cause a wide range of immunity-related adverse events (AEs). Although cardiotoxicity associated with ICI is rare, it is important because of its high mortality rates. In recent years, cases of myocarditis and fatal heart failure have been recorded more often in patients receiving ICI. This review focuses on the mechanisms of cardiotoxicity, methods for the prevention and treatment of these adverse events. Severe cardiovascular consequences associated with the use of ICI are important issues for oncologists, cardiologists and immunologists.

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The authors declare that there are no conflicts of interest present.