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Cardiovascular Toxicity of Immune Checkpoint Inhibitors: Clinical Risk Factors

Flora Pirozzi1, Remo Poto1, Luisa Aran1

  • 1Department of Translational Medical Sciences, Federico II University, Naples, Italy.

Current Oncology Reports
|January 8, 2021
PubMed
Abstract

Insights

Immune checkpoint inhibitors improve cancer treatment but can cause cardiovascular issues like myocarditis. Research is ongoing to identify risk factors for these serious immune-related adverse events.

Area of Science:

  • Immunology
  • Cardiology
  • Oncology

Background:

  • Immune checkpoint inhibitors (ICIs) targeting CTLA-4, PD-1, and PD-L1 have revolutionized cancer therapy.
  • However, ICIs can trigger immune-related adverse events (irAEs), including significant cardiovascular toxicities.

Purpose of the Study:

  • To review the cardiovascular adverse events associated with immune checkpoint inhibitors.
  • To investigate the risk factors contributing to these cardiotoxicities.

Main Methods:

  • Review of current literature on ICI-induced cardiovascular adverse events.
  • Analysis of identified risk factors for cardiotoxicity.

Main Results:

  • ICI therapy, particularly targeting CTLA-4 and PD-1, is linked to cardiotoxic events such as autoimmune myocarditis, pericarditis, and vasculitis.
  • These toxicities suggest a crucial role for CTLA-4 and PD-1 in preventing autoimmunity.

Conclusions:

  • Recognizing risk factors is essential for managing ICI-related cardiotoxicity.
  • Key risk factors include pre-existing cardiovascular conditions, prior cardiotoxic treatments, autoimmune diseases, tumor characteristics, concurrent irAEs, and genetic predispositions.
Keywords:
Cardio-immuno-oncologyCardiotoxicityImmune checkpoint inhibitorsRisk factors

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