TY - JOUR
T1 - Cardiac toxicity associated with immune checkpoint inhibitors
T2 - A systematic review
AU - Shalata, Walid
AU - Abu‐salman, Amjad
AU - Steckbeck, Rachel
AU - Jacob, Binil Mathew
AU - Massalha, Ismaell
AU - Yakobson, Alexander
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Immune checkpoint inhibitors are immune stimulatory drugs used to treat many types of cancer. These drugs are antibodies against inhibitory proteins, such as CTLA‐4 and PD‐1/PD‐L1, that are expressed on immune cells. When bound, they allow for increased stimulation of T cells to fight tumor cells. However, immune checkpoint inhibitors have several immune‐related adverse effects. Many cases have come to light recently of cardiotoxicity as a result of treatment with these drugs. Cardiotoxicity from immune checkpoint inhibitors is unique due to its rarity and high mortality rate. Patients with this toxicity may present with myocarditis, pericarditis, Takotsubo cardiomyopathy, conduction disorders, and others within just a few weeks of starting immune checkpoint inhibitors. We present here a review of the current research on immune checkpoint inhibitors, their associated cardiotoxicities, the timing of presentation of these conditions, lab tests and histology for each condition, and finally the treatment of patients with cardiotoxicity. We observe a positive skew in the onset of presentation, which is significant for the treating physician.
AB - Immune checkpoint inhibitors are immune stimulatory drugs used to treat many types of cancer. These drugs are antibodies against inhibitory proteins, such as CTLA‐4 and PD‐1/PD‐L1, that are expressed on immune cells. When bound, they allow for increased stimulation of T cells to fight tumor cells. However, immune checkpoint inhibitors have several immune‐related adverse effects. Many cases have come to light recently of cardiotoxicity as a result of treatment with these drugs. Cardiotoxicity from immune checkpoint inhibitors is unique due to its rarity and high mortality rate. Patients with this toxicity may present with myocarditis, pericarditis, Takotsubo cardiomyopathy, conduction disorders, and others within just a few weeks of starting immune checkpoint inhibitors. We present here a review of the current research on immune checkpoint inhibitors, their associated cardiotoxicities, the timing of presentation of these conditions, lab tests and histology for each condition, and finally the treatment of patients with cardiotoxicity. We observe a positive skew in the onset of presentation, which is significant for the treating physician.
KW - Cardiac toxicity
KW - Cardiotoxicity
KW - Cytotoxic T‐lymphocyte‐associated protein 4 (CTLA‐4) inhibitors
KW - Immune checkpoint inhibitors (ICIs)
KW - Immune‐related adverse events (IRAE)
KW - Programmed cell death protein 1 (PD‐1)
KW - Programmed death‐ligand 1 (PD‐L1)
UR - http://www.scopus.com/inward/record.url?scp=85117137865&partnerID=8YFLogxK
U2 - 10.3390/cancers13205218
DO - 10.3390/cancers13205218
M3 - Review article
AN - SCOPUS:85117137865
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 20
M1 - 5218
ER -
