Cardiovascular Toxicities Associated with Cancer Immunotherapies

Curr Cardiol Rep. 2017 Mar;19(3):21. doi: 10.1007/s11886-017-0835-0.

Abstract

Purpose of review: We review the cardiovascular toxicities associated with cancer immune therapies and discuss the cardiac manifestations, potential mechanisms, and management strategies.

Recent findings: The recent advances in cancer immune therapy with immune checkpoint inhibitors and adoptive cell transfer have improved clinical outcomes in numerous cancers. The rising use of cancer immune therapy will lead to a higher incidence in immune-related adverse events. Recent studies have highlighted several reports of severe cases of acute cardiotoxic events with immune therapy including fulminant myocarditis. We believe that immune-mediated myocarditis is a driving mechanism behind these cardiovascular toxicities and requires vigilant screening and prompt management with corticosteroids and immune-modulating drugs, especially with combination immune therapies. While the incidence of serious cardiovascular toxicities with immune therapy appears low, these can be life-threatening especially when manifesting as acute immune-mediated myocarditis. Further collaborative studies are needed to effectively identify, characterize, and manage these events.

Keywords: CTLA-4; Cardiovascular toxicities; Checkpoint inhibitors; Immune therapy; Myocarditis; PD-1.

Publication types

  • Review

MeSH terms

  • Adoptive Transfer / adverse effects
  • Humans
  • Immunotherapy / adverse effects*
  • Immunotherapy / methods
  • Myocarditis / etiology*
  • Myocarditis / immunology
  • Neoplasms / therapy*