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The impact of immune checkpoint inhibition on atherosclerosis in cancer patients

Rui Han1, Sheng Han Wang1, Jingchao Tian2

  • 1Department of Cardiovascular Diseases, First Hospital of Jilin University, Jilin University, Changchun, China.

Frontiers in Immunology
|August 18, 2025
PubMed

The emergence of immune checkpoint inhibitors (ICIs) have provided a new perspective for cancer immunotherapy. Immune checkpoint inhibitors significantly improve the survival prognosis of patients with various advanced cancers by inhibiting immune checkpoint molecules, thereby releasing the suppression of T cells by tumor microenvironment, such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1). Immune checkpoint inhibitor (ICI) therapy, while effective, gives rise to distinct immune-related adverse events (irAEs), including cardiovascular toxicities, necessitating focused research efforts to better understand and address these specific complications. The myocarditis-associated toxicity has been extensively studied. This article reviews the latest clinical and preclinical literature on the epidemiology and pathogenesis of ICI-related atherosclerosis, explores the pathophysiological mechanisms by which ICIs promote atherosclerosis, and discusses risk assessment, identification and monitoring methods, and intervention strategies for ICI treatment related atherosclerosis.

Keywords:
atherosclerosisatherosclerotic cardiovascular events (AVEs)immune cells and the signaling pathwaysimmune checkpoint inhibitors (ICIs)tumor immunity

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