Immune Checkpoint Inhibitor-Associated Cardiotoxicity: Current Understanding on Its Mechanism, Diagnosis and Management

• Published in: Frontiers in pharmacology Vol. 10; p. 1350
• Main Authors: Zhou, Yu-Wen, Zhu, Ya-Juan, Wang, Man-Ni, Xie, Yao, Chen, Chao-Yue, Zhang, Tao, Xia, Fan, Ding, Zhen-Yu, Liu, Ji-Yan
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 29.11.2019
• Subjects: cardiotoxicity; cytotoxic T lymphocyte-associated antigen-4; immune checkpoint inhibitors; myocarditis; pericarditis; Pharmacology; programmed cell death protein 1; cardiotoxicity; cytotoxic T lymphocyte-associated antigen-4; programmed cell death protein 1; pericarditis; programmed cell death-ligand 1; myocarditis; immune checkpoint inhibitors
• ISSN: 1663-9812; 1663-9812
• DOI: 10.3389/fphar.2019.01350

Immune checkpoint inhibitors (ICIs) that target cytotoxic T lymphocyte antigen 4, programmed cell death-1, and PD-ligand 1 have revolutionized cancer treatment, achieving unprecedented efficacy in multiple malignancies. ICIs are increasingly being used in early cancer settings and in combination with various other types of therapies, including targeted therapy, radiotherapy, and chemotherapy. However, despite the excellent therapeutic effect of ICIs, these medications typically result in a broad spectrum of toxicity reactions, termed immune-related adverse events (irAEs). Of all irAEs, cardiotoxicity, uncommon but with high mortality, has not been well recognized. Herein, based on previous published reports and current evidence, we summarize the incidence, diagnosis, clinical manifestations, underlying mechanisms, treatments, and outcomes of ICI-associated cardiotoxicity and discuss possible management strategies. A better understanding of these characteristics is critical to managing patients with ICI-associated cardiotoxicity.