Long-Term Cardiovascular Toxicity of Immunotherapy: Too Important to Ignore

Area of Science:

• Oncology
• Cardiology
• Immunology

Background:

• Immunotherapy has revolutionized cancer treatment, improving survival rates across various cancer types and stages.
• Cancer and atherosclerosis share common risk factors, molecular pathways, and immune dysregulation.
• Long-term survivors of immunotherapy present new clinical challenges regarding potential unforeseen toxicities.

Purpose of the Study:

• To review the association between long-term immune checkpoint inhibitor therapy and the worsening of atherosclerosis.
• To highlight the increased incidence of atherosclerosis-related cardiovascular events in cancer survivors treated with immunotherapy.
• To provide an overview for clinicians managing cancer patients undergoing immunotherapy.

Main Methods:

• Review of available scientific evidence on immunotherapy and atherosclerosis.
• Analysis of molecular processes and inflammatory states linking cancer and cardiovascular disease.
• Examination of clinical data on long-term side effects of immune checkpoint inhibitors.

Main Results:

• Long-term exposure to immune checkpoint inhibitors is linked to the emergence or worsening of atherosclerosis.
• Atherosclerosis-related cardiovascular events, including myocardial infarction and stroke, are increased in this patient population.
• The benefits of immunotherapy may be offset by increased long-term cardiovascular morbidity.

Conclusions:

• Worsening atherosclerosis is a significant long-term toxicity of immune checkpoint inhibitors.
• Clinicians must consider the cardiovascular risks in patients receiving long-term immunotherapy.
• Multidisciplinary care is essential to manage the complex interplay between cancer treatment and cardiovascular health.