Immune checkpoint inhibitor-associated myocarditis : Case reports and a review of the literature

T E Osinga; S F Oosting; P van der Meer; R A de Boer; B C Kuenen; A Rutgers; L Bergmann; T H Oude Munnink; M Jalving; M van Kruchten

doi:10.1007/s12471-021-01655-7

Immune checkpoint inhibitor-associated myocarditis : Case reports and a review of the literature

Neth Heart J. 2022 Jun;30(6):295-301. doi: 10.1007/s12471-021-01655-7. Epub 2022 Jan 21.

Authors

T E Osinga¹, S F Oosting¹, P van der Meer², R A de Boer², B C Kuenen³, A Rutgers⁴, L Bergmann⁵, T H Oude Munnink⁶, M Jalving¹, M van Kruchten⁷

Affiliations

¹ Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
² Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
³ Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands.
⁴ Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
⁵ Medical Clinic II, J.W. Goethe University, Frankfurt, Germany.
⁶ Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
⁷ Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. m.van.kruchten@umcg.nl.

Abstract

Immune checkpoint inhibitors (ICIs) are increasingly recognised to effectuate long-lasting therapeutic responses in solid tumours. However, ICI therapy can also result in various immune-related adverse events, such as ICI-associated myocarditis, a rare but serious complication. The clinical spectrum is wide and includes asymptomatic patients and patients with fulminant heart failure, making it challenging to diagnose this condition. Furthermore, the optimal diagnostic algorithm and treatment of ICI-associated myocarditis is unknown. In this review, we describe two cases on both ends of the spectrum and discuss the challenges in recognising, diagnosing and treating ICI-associated myocarditis.

Keywords: Associated myocarditis; Cardiac biomarkers; Cardio-oncology; ICI-associated myocarditis; Immune checkpoint inhibitor.

Publication types

Review