What question did this study set out to answer?

This review aims to evaluate and synthesize existing literature on cardiotoxicity risk related to immune checkpoint inhibitors in cancer treatment.

January 10, 2026Current Problems in Cardiology

Balancing hope and heart: An umbrella review of cardiotoxicity in immune checkpoint inhibitor cancer therapies

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Key result

Combination ICIs elevate myocarditis risk ~3-fold versus monotherapy.

Why the study?

Despite their therapeutic promise, immune checkpoint inhibitors carry risks of cardiotoxicity, prompting an evaluation of published systematic reviews and meta-analyses to provide a cohesive overview across cancer types and regimens.

What is the risk of cardiotoxicity associated with immune checkpoint inhibitor therapies in cancer patients?

Population

Cancer patients receiving immune checkpoint inhibitor therapy in published systematic reviews and meta-analyses

Comparison

Dual ICIs or PD-1/PD-L1 inhibitors plus chemotherapy vs monotherapies

Design

Umbrella review of systematic reviews and meta-analyses

Authors

YSYashendra Sethi SSSaurabh SinghalSwami Vivekanand Subharti University ASApoorv Pratap SinghSwami Vivekanand Subharti University

Discussion

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Implication

Clinicians should intensify myocarditis surveillance with dual ICIs; confirms elevated risk and high mortality in umbrella synthesis.

Key Points

This review aims to evaluate and synthesize existing literature on cardiotoxicity risk related to immune checkpoint inhibitors in cancer treatment.
Conducted umbrella review analyzing systematic reviews and meta-analyses on ICI-related cardiotoxicity.
Performed comprehensive searches in PubMed, Scopus, and Google Scholar until January 2025.
Utilized JBI checklist to assess the quality of the included studies.
Cardiotoxicity incidence linked to ICIs ranges from 0.8% to 1.3%.
Myocarditis is the most common adverse event, affecting 0.5% to 0.72% of patients.
Dual therapies for ICIs increase myocarditis risk by 3.07 times compared to monotherapy.
Combination of PD-1/PD-L1 inhibitors with chemotherapy raises severe cardiotoxicity risk by 63%.
NSCLC patients face a 97% higher risk of all-grade cardiotoxicity with combination treatments.

Structured PICO

What is the risk of cardiotoxicity associated with immune checkpoint inhibitor therapies in cancer patients?

Population

Cancer patients receiving immune checkpoint inhibitor (ICI) therapy

Intervention

Immune checkpoint inhibitors (ICIs), including monotherapy and combination therapies (dual ICIs or PD-1/PD-L1 inhibitors with chemotherapy)

Comparator

Monotherapy (for combination therapy comparisons)

Outcome

Incidence of cardiotoxicity and cardiac immune-related adverse events (including myocarditis)safety

ICI therapy carries a small but significant risk of severe cardiotoxicity, particularly myocarditis with high mortality, which is markedly increased with combination therapies.

Limitations

Disparate findings among included studies, with some reporting no significant increase in cardiac events

Cite This Study

Sethi et al. (2025) studied this question. Combination immunotherapy significantly elevates myocarditis risk by 3.07-fold, with a 37.7% mortality rate among affected patients.

synapsesocial.com/papers/6963223291e05aa366cb8c4d https://doi.org/10.1016/j.cpcardiol.2025.103257

Topics

Cardio-oncology Heart failure Myocarditis HFrEF treatment

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Balancing hope and heart: An umbrella review of cardiotoxicity in immune checkpoint inhibitor cancer therapies

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Balancing hope and heart: An umbrella review of cardiotoxicity in immune checkpoint inhibitor cancer therapies

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

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