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

Case Rep Oncol. 2019 Mar 21;12(1):260-276. doi: 10.1159/000498985. eCollection 2019 Jan-Apr.

Abstract

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.

Keywords: Autoimmune; Cardio-oncology; Cardiotoxicity; Immune checkpoint inhibitors; Myocarditis.

Publication types

  • Case Reports