Immune checkpoint inhibitors are associated with cardiovascular toxicity, necessitating enhanced risk assessment tools, baseline evaluations, and potential prophylactic strategies.
What are the mechanisms, risk factors, and management strategies for cardiovascular toxicity associated with immune checkpoint inhibitors in cancer patients?
This review highlights the critical need for awareness, risk assessment, and proactive management of cardiovascular toxicities in cancer patients treated with immune checkpoint inhibitors.
Cancer remains a prominent global cause of mortality, second only to cardiovascular disease. The past decades have witnessed substantial advancements in anti-cancer therapies, resulting in improved outcomes. Among these advancements, immunotherapy has emerged as a promising breakthrough, leveraging the immune system to target and eliminate cancer cells. Despite the remarkable potential of immunotherapy, concerns have arisen regarding associations with adverse cardiovascular events. This review examines the complex interplay between immunotherapy and cardiovascular toxicity and provides an overview of immunotherapy mechanisms, clinical perspectives, and potential biomarkers for adverse events, while delving into the intricate immune responses and evasion mechanisms displayed by cancer cells. The focus extends to the role of immune checkpoint inhibitors in cancer therapy, including CTLA-4, PD-1, and PD-L1 targeting antibodies. This review underscores the multifaceted challenges of managing immunotherapy-related cardiovascular toxicity. Risk factors for immune-related adverse events and major adverse cardiac events are explored, encompassing pharmacological, treatment-related, autoimmune, cardiovascular, tumor-related, social, genetic, and immune-related factors. The review also advocates for enhanced medical education and risk assessment tools to identify high-risk patients for preventive measures. Baseline cardiovascular evaluations, potential prophylactic strategies, and monitoring of emerging toxicity symptoms are discussed, along with the potential of adjunct anti-inflammatory therapies.
Green et al. (Tue,) conducted a review in Cancer and immunotherapy-related cardiovascular toxicity. Immune checkpoint inhibitors (CTLA-4, PD-1, and PD-L1 targeting antibodies) was evaluated. Immune checkpoint inhibitors are associated with cardiovascular toxicity, necessitating enhanced risk assessment tools, baseline evaluations, and potential prophylactic strategies.