What the Cardiologist Needs to Know About Cancer Immunotherapies and Complications

Curr Treat Options Oncol. 2021 May 26;22(6):53. doi: 10.1007/s11864-021-00844-1.

Abstract

Immunotherapies have transformed the current landscape for cancer treatment and demonstrated unparalleled improvements in survival rates. Now, a third of cancer patients are eligible for treatment with the most widely used class of immunotherapy, immune checkpoint inhibitors (ICIs). As more patients are treated with these novel agents, it is critical for both oncologists and subspecialists to establish a better understanding of the adverse events which can occur. The incidence of myocarditis associated with ICI therapy has been reported to be between 0.27 and 1.14%, 5 times that of myocarditis from other cancer therapies, and, of those patients, 20-50% develop a fulminant form. However, because of unclear risk factors, a broad clinical spectrum, and lack of specific noninvasive studies for diagnosis, the care of patients with ICI-associated cardiotoxicity can be challenging. Here, we have provided a brief overview of the current immunotherapy agents with a focus on the emerging evidence regarding diagnosis and management of cardiac adverse events.

Keywords: Cardiotoxicity; Immune checkpoint inhibitor; Immune related adverse event; Myocarditis; irAE.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Cardiac Imaging Techniques
  • Cardiologists
  • Cardiotoxicity / diagnosis
  • Cardiotoxicity / etiology
  • Cardiotoxicity / therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immunotherapy, Adoptive / adverse effects
  • Myocarditis / chemically induced
  • Neoplasms / drug therapy*
  • Takotsubo Cardiomyopathy / chemically induced
  • Takotsubo Cardiomyopathy / therapy

Substances

  • Immune Checkpoint Inhibitors