TY - JOUR
T1 - Cardiovascular Toxicities of Immune Checkpoint Inhibitors
T2 - JACC Review Topic of the Week
AU - Ball, Somedeb
AU - Ghosh, Raktim K.
AU - Wongsaengsak, Sariya
AU - Bandyopadhyay, Dhrubajyoti
AU - Ghosh, Gopal Chandra
AU - Aronow, Wilbert S.
AU - Fonarow, Gregg C.
AU - Lenihan, Daniel J.
AU - Bhatt, Deepak L.
N1 - Publisher Copyright:
© 2019 American College of Cardiology Foundation
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Immune checkpoint inhibitors (ICIs) have been an important therapeutic advance in the field of cancer medicine, resulting in a significant improvement in survival of patients with advanced malignancies. Recent reports provided greater insights into the incidence of cardiovascular adverse events (CVAEs) with ICI use. Myocarditis is the most common CVAE associated with ICI. Pericardial diseases, Takotsubo syndrome, arrhythmias, and vasculitis constitute other significant AEs. Physicians should be aware of these infrequent, but potentially fatal toxicities associated with ICIs as their therapeutic use becomes widespread with a myriad of approvals by the U.S. Food and Drug Administration. Management involves prompt administration of high-dose corticosteroids and discontinuation of ICIs in severe myocarditis. This review summarizes the most updated evidence on epidemiology, pathophysiological mechanisms, and management strategies of various CVAEs associated with ICIs. Highlights from recent guidelines published by National Comprehensive Cancer Network on ICI-related CV toxicities have also been incorporated.
AB - Immune checkpoint inhibitors (ICIs) have been an important therapeutic advance in the field of cancer medicine, resulting in a significant improvement in survival of patients with advanced malignancies. Recent reports provided greater insights into the incidence of cardiovascular adverse events (CVAEs) with ICI use. Myocarditis is the most common CVAE associated with ICI. Pericardial diseases, Takotsubo syndrome, arrhythmias, and vasculitis constitute other significant AEs. Physicians should be aware of these infrequent, but potentially fatal toxicities associated with ICIs as their therapeutic use becomes widespread with a myriad of approvals by the U.S. Food and Drug Administration. Management involves prompt administration of high-dose corticosteroids and discontinuation of ICIs in severe myocarditis. This review summarizes the most updated evidence on epidemiology, pathophysiological mechanisms, and management strategies of various CVAEs associated with ICIs. Highlights from recent guidelines published by National Comprehensive Cancer Network on ICI-related CV toxicities have also been incorporated.
KW - cancer therapeutics-related cardiac dysfunction
KW - cytotoxic T lymphocyte antigen-4
KW - methylprednisolone
KW - myocarditis
KW - programmed cell death ligand 1
KW - programmed cell death protein 1
KW - vasculitis
UR - http://www.scopus.com/inward/record.url?scp=85072228965&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2019.07.079
DO - 10.1016/j.jacc.2019.07.079
M3 - Review article
C2 - 31558256
AN - SCOPUS:85072228965
SN - 0735-1097
VL - 74
SP - 1714
EP - 1727
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 13
ER -