Immune checkpoint inhibitors (ICIs) are a major advance in oncology and have become first- or second-line therapy for over 50% of oncology patients. ICI-associated myocarditis is a complication that, although rare, has a high mortality rate. We present a case of ICI-associated myocarditis presenting as complete heart block. Traditional treatment with high-dose steroids was abandoned in this case, owing to steroid-induced psychosis. Alternative treatment with immunomodulators was initiated with a good response. This case highlights the variable presentation of ICI-associated myocarditis. As use of ICIs continues to expand, an understanding of their adverse reactions and best treatments will be needed.
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http://dx.doi.org/10.1016/j.cjco.2022.07.002 | DOI Listing |
PLoS One
December 2024
Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America.
Background: There is an urgent need to better understand the diverse presentations, risk factors, and outcomes of immune checkpoint inhibitor (ICI)-associated cardiovascular toxicity. There remains a lack of consensus surrounding cardiovascular screening, risk stratification, and clinical decision-making in patients receiving ICIs.
Methods: We conducted a single center retrospective cohort study including 2165 cancer patients treated with ICIs between 2013 and 2020.
Basic Res Cardiol
November 2024
Department of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare but potentially fatal immune-related adverse event. Previously, we reported a case of ICI-associated myocarditis with elevated autoantibodies to 4E-binding protein 3 (4E-BP3). Recent studies have suggested that 4E-BP3 may play an important role in tumor development.
View Article and Find Full Text PDFFront Immunol
September 2024
Tsukuba Life Science Innovation Program (T-LSI), School of Integrative and Global Majors (SIGMA), University of Tsukuba, Tsukuba, Japan.
Background: Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare, but potentially fatal, immune-related adverse event. Hence, identifying biomarkers is critical for selecting and managing patients receiving ICI treatment. Serum autoantibodies (AAbs) in patients with ICI myocarditis may serve as potential biomarkers for predicting, diagnosing, and prognosing ICI myocarditis.
View Article and Find Full Text PDFEur Heart J Case Rep
September 2024
Department of Cardiology, General Hospital Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium.
Background: ICI-associated myocarditis is a rare but severe and potentially life-threatening complication that typically manifests shortly after treatment initiation. It may present in many different ways, ranging from fulminant to non-fulminant, even including clinical and electrocardiographic findings mimicking ST-elevation Myocardial Infarction (STEMI).
Case Summary: A 72-year-old woman with a history of non-small cell lung carcinoma presented at the emergency department with symptoms of general asthenia and chest pain, following recent ICI-therapy initiation.
Postgrad Med J
September 2024
Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, No 9, Chongwen Road, Suzhou City 215000, China.
Background: Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment; however, the emergence of ICI-associated myocarditis (ICI-MC) presents a severe and potentially fatal complication with poorly understood pathophysiological mechanisms. This study aimed to identify crucial immune-related genes in ICI-MC and uncover potential therapeutic targets using bioinformatics.
Methods: Using the GSE180045 dataset, which includes three groups-Group A: ICI patients without immune adverse events, Group B: ICI patients with non-myocarditis immune adverse events, and Group C: ICI patients with myocarditis-we analyzed differentially expressed genes (DEGs) between ICI-MC samples (Group C) and non-myocarditis controls (Groups A and B).
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