Cardiotoxicity danger in immunotherapy

Area of Science:

• Oncology
• Cardiology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis are FDA-approved for various cancers, showing efficacy in non-small cell lung cancer.
• Despite treatment successes, ICIs can cause severe cardiotoxicity, particularly myocarditis, with unclear molecular mechanisms.

Purpose of the Study:

• To highlight the risks associated with ICI anticancer therapy.
• To emphasize the need for detailed monitoring and investigation of ICI-induced cardiotoxicity.
• To propose extending molecular and systemic knowledge of myocarditis etiology.

Main Methods:

• Review of current literature on ICI therapy and cardiotoxicity.
• Analysis of the clinical problem posed by unexplained myocarditis.
• Discussion of the need for improved monitoring and understanding of risk factors.

Main Results:

• ICI therapy, while effective, presents significant risks of cardiotoxicity.
• The molecular mechanisms underlying ICI-induced myocarditis remain poorly understood.
• Current cardiac monitoring for patients on ICIs is often cost-ineffective.

Conclusions:

• Further investigation into the etiology of ICI-induced myocarditis, including the role of protein kinases, is essential.
• Enhanced understanding will improve patient safety and aid clinicians in predicting adverse events.
• Detailed registration of cardiotoxicity events is needed for a global overview of myocarditis frequency.