Cardiac Toxicity Associated with Immune Checkpoint Inhibitors: Case Series and Review of the Literature

The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormali...

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Bibliographic Details
Published in:Case reports in oncology 2019-01, Vol.12 (1), p.260-276
Main Authors: Agrawal, Nikhil, Khunger, Arjun, Vachhani, Pankit, Colvin, Teresa A., Hattoum, Alexander, Spangenthal, Edward, Curtis, Anne B., Dy, Grace K., Ernstoff, Marc S., Puzanov, Igor
Format: Article
Language:English
Subjects:
Autoimmune
Cardio-oncology
Cardiomyopathy
Cardiotoxicity
Case Report
Case reports
Clinical medicine
Cytomegalovirus
Drug dosages
Dyspnea
Electrocardiography
Heart failure
Immune checkpoint inhibitors
Immunoglobulins
Immunotherapy
Lung cancer
Melanoma
Myocarditis
Oncology
Systematic review
Ultrasonic imaging
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Summary:The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormalities of the heart and even fulminant myocarditis. Although rare, myocarditis is a potentially fatal adverse effect of ICI therapy. We present a series of five cases of ICI-related cardio-toxicity diagnosed and managed at Roswell Park Comprehensive Cancer Center along with a review of published case reports in the literature. Our series highlights the importance of high clinical suspicion, early diagnosis of myocarditis, and prompt initiation of immunosuppressive therapy.
ISSN:1662-6575
1662-6575
DOI:10.1159/000498985