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Heart failure in cancer: role of checkpoint inhibitors

Murilo Delgobo1,2, Stefan Frantz1,2

  • 1Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.

Journal of Thoracic Disease
|February 1, 2019
PubMed

Insights

Immune checkpoint inhibitors improve cancer outcomes but can cause severe heart problems like myocarditis and heart failure. Understanding these immune-related adverse events is crucial for patient safety.

Area of Science:

  • Oncology
  • Immunology
  • Cardiology

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, improving outcomes for various malignancies.
  • Despite efficacy, ICIs are associated with immune-related adverse events (irAEs).
  • Cardiac toxicity, including myocarditis and heart failure, is a serious, increasingly recognized irAE.

Purpose of the Study:

  • To review the mechanisms underlying cardiac toxicity induced by ICIs.
  • To highlight the clinical significance of cardiovascular events associated with ICI therapy.

Main Methods:

  • Literature review of studies on ICI-induced cardiotoxicity.
  • Discussion of proposed mechanisms involving CTLA-4 and PD-1 pathways.

Main Results:

  • ICI therapy can precipitate severe cardiac events, including fulminant myocarditis and fatal heart failure.
  • Mechanisms involve immune system activation against cardiac tissues.

Conclusions:

  • Cardiotoxicity is a significant concern in ICI therapy, requiring careful monitoring.
  • An interdisciplinary approach involving oncologists, cardiologists, and immunologists is essential for managing ICI-induced cardiotoxicity.
Keywords:
Myocarditiscardiac toxicitycardio-oncologycheckpoint inhibitors

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