Immune Checkpoint Inhibitor-Associated Cardiotoxicity: Current Understanding on Its Mechanism, Diagnosis and...

Area of Science:

• Oncology
• Immunology
• Cardiology

Background:

• Immune checkpoint inhibitors (ICIs) targeting CTLA-4, PD-1, and PD-L1 have transformed cancer treatment across various malignancies.
• ICIs are increasingly used in early-stage cancers and in combination with other therapies like targeted therapy, radiotherapy, and chemotherapy.
• While effective, ICIs can cause immune-related adverse events (irAEs), with cardiotoxicity being a serious, high-mortality complication that is not widely recognized.

Purpose of the Study:

• To comprehensively review the incidence, diagnosis, clinical manifestations, mechanisms, treatments, and outcomes of ICI-associated cardiotoxicity.
• To discuss potential management strategies for patients experiencing ICI-induced heart damage.
• To enhance clinical understanding and recognition of this critical irAE.

Main Methods:

• Systematic review of published reports and current evidence on ICI-associated cardiotoxicity.
• Analysis of incidence, diagnostic criteria, clinical presentations, and pathological mechanisms.
• Evaluation of treatment approaches and patient outcomes.

Main Results:

• ICI-associated cardiotoxicity is an uncommon but potentially fatal adverse event.
• Key manifestations, diagnostic challenges, and underlying immunological mechanisms are detailed.
• Current treatment strategies and their impact on patient outcomes are summarized.

Conclusions:

• A thorough understanding of ICI-associated cardiotoxicity is essential for timely diagnosis and effective management.
• Recognizing and addressing cardiac irAEs can improve patient outcomes in ICI therapy.
• Further research into management strategies is warranted to mitigate the risks of cardiotoxicity.