Cardiotoxicities associated with immune checkpoint inhibitors

Current Problems in Cancer
Shu Yang, Aarti Asnani

Abstract

This review provides an overview of clinical manifestations, diagnostic approaches, and management strategies for cardiotoxicities associated with the use of immune checkpoint inhibitors (ICI). ICI therapy represents a novel treatment modality for advanced-stage malignancies, including melanoma, metastatic renal cell cancer, and non-small cell lung cancers. ICIs have been shown to provide significant mortality benefit and are generally well-tolerated. The major adverse effects associated with ICIs are immune-mediated toxicities, which can affect multiple different organ systems. Immune-mediated cardiotoxicity is quickly gaining recognition as a rare but devastating consequence of ICI therapy. ICI-associated cardiotoxicity can manifest in a variety of ways, including fulminant lymphocytic myocarditis, supraventricular and ventricular arrhythmias, pericardial disease, and even Takotsubo-like cardiomyopathy. While not entirely clear, the primary mechanism of injury has been hypothesized to involve hyperactivation and infiltration of cytotoxic T-cells into cardiovascular tissue. The diagnosis is typically made using cardiac biomarkers and imaging, in conjunction with endomyocardial biopsy when necessary. Treatment options remain li...Continue Reading

Citations

Mar 5, 2020·Asia-Pacific Journal of Clinical Oncology·Yingxian Liu, Wei Wu
Jun 15, 2019·Heart Failure Reviews·Isabela Bispo Santos da Silva CostaLudhmila Abrahão Hajjar
Oct 3, 2020·International Journal of Molecular Sciences·Grzegorz SławińskiEwa Lewicka
Apr 2, 2020·Nature Reviews. Cardiology·Joerg Herrmann
Mar 23, 2021·Expert Opinion on Drug Safety·Remo PotoGilda Varricchi
Mar 27, 2021·World Journal of Clinical Oncology·Asim KichlooManidhar Lekkala
Apr 8, 2021·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Neeraj Chhabra, Joseph Kennedy
May 19, 2021·Journal of Cardiovascular Pharmacology·Andreina CarbonePaolo Golino
Jul 19, 2021·The American Journal of Emergency Medicine·Demis N LipePatrick Chaftari
Jul 2, 2021·European Journal of Heart Failure·Nestor Rubio-InfanteGuillermo Torre-Amione

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