卡度尼利单抗致免疫性心肌炎1例

详细信息

收稿日期: 2023-11-20

刊出日期: 2024-12-13

One case of immune-mediated myocarditis induced by Cadonilimab monoclonal antibody

- Department of Cardiology, Qingpu Branch, Zhongshan Hospital Affiliated to Fudan University, Shanghai, 201700, China

More Information

Received Date: 20 November 2023

Publish Date: 13 December 2024

摘要: 免疫检查点抑制剂(immune checkpoint inhibitors，ICIs)已用于治疗多种恶性肿瘤，使肿瘤患者受益。卡度尼利单抗是2022年6月获批的首个PD-1/CTLA-4肿瘤双ICIs，迄今为止尚无使用卡度尼利单抗所致的ICIs相关性心肌炎的报道。本文介绍了1例使用卡度尼利单抗3个周期后诊断为重症ICIs相关性心肌炎，行糖皮质激素治疗后病情显著改善的病例。此病例强调了卡度尼利单抗诱导ICIs相关性心肌炎的潜在风险，为此类新型免疫抑制剂导致心肌炎的诊断和治疗提供思路。
- 卡度尼利单抗 /
- 免疫检查点抑制剂 /
- 免疫性心肌炎
Abstract: Immune checkpoint inhibitors(ICIs) have been used to treat various malignant tumors, and benefit cancer patients. Cadonilimab is the first PD-1/CTLA-4 tumor dual ICIs approved in June 2022, and there have been no reports of ICIs associated myocarditis caused by Cadonilimab. This article introduces one case of severe ICIs related myocarditis diagnosed after 3 cycles of using Cadonilimab, and his condition was improved significantly after glucocorticoids treatment. This case highlights the potential risk of ICIs related myocarditis induced by Cadonilimab, providing insights for the diagnosis and treatment of ICIs related myocarditis.
- Cadonilimab /
- immune checkpoint inhibitors /
- immune myocarditis

图 1 入院心电图

Figure 1. Admission ECG

下载: 全尺寸图片幻灯片

图 2 冠脉造影未见狭窄

Figure 2. Coronary angiography shows no stenosis

下载: 全尺寸图片幻灯片

图 3 入院前心电图

Figure 3. Electrocardiogram before admission

下载: 全尺寸图片幻灯片

图 4 出院心电图

Figure 4. Discharge ECG

下载: 全尺寸图片幻灯片

图 5 患者cTnI、CK-MB及NT-proBNP的变化曲线

Figure 5. Change curves of cTnI, CK-MB, and NT proBNP in patients

下载: 全尺寸图片幻灯片

[1]	Bonaca MP, Olenchock BA, Salem JE, et al. Myocarditis in the setting of cancer therapeutics: proposed case definitions for emerging clinical syndromes in cardio-oncology[J]. Circulation, 2019, 140(2): 80-91.
[2]	王妍, 陈慧勇, 林瑾仪, 等. 免疫检查点抑制剂相关心肌炎临床诊疗实施建议[J]. 中国临床医学, 2023, 30(2): 368-390.
[3]	Zhang LL, Zlotoff DA, Awadalla M, et al. Major adverse cardiovascular events and the timing and dose of corticosteroids in immune checkpoint inhibitor-associated myocarditis[J]. Circulation, 2020, 141(24): 2031-2034. doi: 10.1161/CIRCULATIONAHA.119.044703
[4]	汪道文, 惠汝太. 推行暴发性心肌炎处理的中国方案, 挽救更多生命[J]. 中华心血管病杂志, 2022, 50(3): 212-218.
[5]	刘德敏, 路旭阳, 谷国强. 免疫检查点抑制剂致心脏毒性的研究进展[J]. 临床心血管病杂志, 2023, 39(6): 481-486. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2023.06.014
[6]	Keam SJ. Cadonilimab: First Approval[J]. Drugs, 2022, 82(12): 1333-1339. doi: 10.1007/s40265-022-01761-9
[7]	Chen PY, Li ZY, Cai SQ. Case Report: Cadonilimab-related toxic epidermal necrolysis-like reactions successfully treated with supplemental Adalimumab[J]. Front Immunol, 2023, 14: 1188523. doi: 10.3389/fimmu.2023.1188523