Cardiotoxicity associated with immune checkpoint inhibitors: Current status and future challenges

Lu Gan; Demin Liu; Yanan Ma; Xuening Chen; Aihui Dai; Sihan Zhao; Xiaoxue Jin; Guoqiang Gu

doi:10.3389/fphar.2022.962596

Cardiotoxicity associated with immune checkpoint inhibitors: Current status and future challenges

Front Pharmacol. 2022 Aug 30:13:962596. doi: 10.3389/fphar.2022.962596. eCollection 2022.

Authors

Lu Gan¹, Demin Liu², Yanan Ma², Xuening Chen², Aihui Dai², Sihan Zhao², Xiaoxue Jin², Guoqiang Gu²

Affiliations

¹ Research Laboratory of Emergency Medicine, Emergency Department, West China Hospital, Sichuan University, Chengdu, China.
² Cardiology Department, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

Abstract

Immune checkpoint inhibitors (ICIs) are the most notable breakthrough in tumor treatment. ICIs has been widely used in tumor patients, but its wide range of immune-related adverse events (irAEs) should not be ignored. irAEs can be involved in any organ system, including immune-related cardiotoxicity. Although the cardiotoxicity induced by immune checkpoint inhibitors is rare, it is extremely lethal and has attracted increasing attention. PD-1 and PD-L1 are expressed in human cardiomyocytes, so the application of PD-1/PDL-1 inhibitors can cause many adverse reactions to the cardiovascular system. This review summarizes the latest epidemiological evidence on the cardiovascular toxicity of programmed cell death protein-1(PD-1)/programmed cell death ligand-1(PD-L1) inhibitors and the clinical manifestations, as well as the potential pathological mechanisms. These updates may provide a novel perspective for monitoring early toxicity and establishing appropriate treatment for patients with ICI-related cardiotoxicity.

Keywords: cardiotoxicity; immune checkpoint inhibitors; myocarditis; oncotherapy; tumor immunotherapy.

Publication types

Review