Risk Factors for Immune Checkpoint Inhibitor-Mediated Cardiovascular Toxicities

Area of Science:

• Cardiology
• Oncology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, particularly for advanced malignancies.
• However, cardiovascular immune-related adverse events (irAEs), such as myocarditis, pericarditis, and vasculitis, present significant mortality and morbidity risks.
• Current understanding of clinical risk factors for these events remains limited.

Purpose of the Study:

• To review the predominant risk factors associated with cardiovascular irAEs in patients undergoing ICI therapy.
• To highlight the need for an a priori risk strategy to identify patients at high risk for developing cardiovascular irAEs.
• To provide insights into risk factors to improve clinical care and disease management.

Main Methods:

• Literature review focusing on cardiovascular immune-related adverse events associated with immune checkpoint inhibitors.
• Analysis of identified risk factors including combination therapies, patient demographics, and tumor type.
• Synthesis of current evidence to delineate prevailing risk factors for cardiovascular irAEs.

Main Results:

• ICI combination therapy is a significant risk factor for ICI-mediated myocarditis.
• Concomitant use of ICIs with other anti-cancer treatments (tyrosine kinase inhibitors, radiation, chemotherapy) increases the risk of cardiovascular irAEs.
• Additional risk factors identified include female sex, pre-existing cardiovascular disease, and specific tumor types.

Conclusions:

• Understanding the impact of identified risk factors is crucial for predicting and managing cardiovascular irAEs.
• Developing a proactive risk assessment strategy is essential for patient care.
• Further research into risk stratification will aid clinicians in optimizing treatment and monitoring for cardiovascular complications.