Immune checkpoint inhibitors are associated with infrequent but potentially fatal cardiovascular adverse events, most commonly myocarditis, which requires prompt management with high-dose corticosteroids.
What are the cardiovascular toxicities associated with immune checkpoint inhibitors and how should they be managed?
This review highlights the infrequent but potentially fatal cardiovascular toxicities of immune checkpoint inhibitors, emphasizing prompt recognition and management with high-dose corticosteroids.
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.
Ball et al. (Mon,) conducted a review in Cardiovascular adverse events associated with immune checkpoint inhibitors. Immune checkpoint inhibitors (ICIs) was evaluated. Immune checkpoint inhibitors are associated with infrequent but potentially fatal cardiovascular adverse events, most commonly myocarditis, which requires prompt management with high-dose corticosteroids.