Immune checkpoint inhibitors and cardiovascular toxicity

Immune checkpoint inhibitors are a new class of anticancer therapies that amplify T-cell-mediated immune responses against cancer cells. Immune checkpoint inhibitors have shown important benefits in phase 3 trials, and several agents have been approved for specific malignancies. Although adverse eve...

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Bibliographic Details
Published in:The lancet oncology 2018-09, Vol.19 (9), p.e447-e458
Main Authors: Lyon, Alexander R, Yousaf, Nadia, Battisti, Nicolò M L, Moslehi, Javid, Larkin, James
Format: Article
Language:English
Subjects:
Apoptosis
Biopsy
Cancer
Cardiac arrhythmia
Clinical trials
Drug dosages
EKG
Epidemiology
FDA approval
Heart attacks
Heart failure
Immune checkpoint inhibitors
Immune response (cell-mediated)
Immune system
Immunotherapy
Inflammation
Kinases
Ligands
Lymphocytes T
Medical imaging
Melanoma
Metastasis
Nonsteroidal anti-inflammatory drugs
Risk factors
Surveillance
Toxicity
Ultrasonic imaging
Weaning
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Summary:Immune checkpoint inhibitors are a new class of anticancer therapies that amplify T-cell-mediated immune responses against cancer cells. Immune checkpoint inhibitors have shown important benefits in phase 3 trials, and several agents have been approved for specific malignancies. Although adverse events from immune checkpoint inhibitors are a common occurrence, cardiotoxic effects are uncommon, but are often serious complications with a relatively high mortality. Most cardiotoxic effects appear to be inflammatory in nature. Clinical assessment of a combination of biomarkers, electrocardiography, cardiac imaging, and endomyocardial biopsy can be used to confirm a possible diagnosis. In this Review, we discuss the epidemiology of immune checkpoint inhibitor-mediated cardiotoxic effects, as well as their clinical presentation, subtypes, risk factors, pathophysiology, and clinical management, including the introduction of a new surveillance strategy.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(18)30457-1