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Cardiotoxicity of Immune Checkpoint Inhibitors.
Patel, Rushin P; Parikh, Rohan; Gunturu, Krishna S; Tariq, Rana Zouveenoor; Dani, Sourbha S; Ganatra, Sarju; Nohria, Anju.
  • Patel RP; Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
  • Parikh R; Vascular Medicine Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA.
  • Gunturu KS; Cancer Survivorship Program, Division of Hematology Oncology, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA.
  • Tariq RZ; Division of Cardiovascular Medicine, Indiana University Health, Bloomington, IN, USA.
  • Dani SS; Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA.
  • Ganatra S; Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA. Sarju.ganatra@lahey.org.
  • Nohria A; Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. Anohria@bwh.harvard.edu.
Curr Oncol Rep ; 23(7): 79, 2021 05 03.
Article in English | MEDLINE | ID: covidwho-1384599
ABSTRACT
PURPOSE OF REVIEW Immune checkpoint inhibitors (ICIs) have improved the survival of several cancers. However, they may cause a wide range of immune-related adverse events (irAEs). While most irAEs are manageable with temporary cessation of ICI and immunosuppression, cardiovascular toxicity can be associated with high rates of morbidity and mortality. As ICIs evolve to include high-risk patients with preexisting cardiovascular risk factors and disease, the risk and relevance of ICI-associated cardiotoxicity may be even higher. RECENT

FINDINGS:

Several cardiovascular toxicities such as myocarditis, stress cardiomyopathy, and pericardial disease have been reported in association with ICIs. Recent findings also suggest an increased risk of atherosclerosis with ICI use. ICI-associated myocarditis usually occurs early after initiation and can be fulminant. A high index of suspicion is required for timely diagnosis. Prompt treatment with high-dose corticosteroids is shown to improve outcomes. Although the overall incidence is rare, ICI cardiotoxicity, particularly myocarditis, is associated with significant morbidity and mortality, making it a major therapy-limiting adverse event. Early recognition and prompt treatment with the cessation of ICI therapy and initiation of high-dose corticosteroids are crucial to improve outcomes. Cardio-oncologists will need to play an important role not just in the management of acute cardiotoxicity but also to reduce the risk of long-term sequelae.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Atherosclerosis / Cardiotoxicity / Immune Checkpoint Inhibitors / Myocarditis / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Curr Oncol Rep Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: S11912-021-01070-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Atherosclerosis / Cardiotoxicity / Immune Checkpoint Inhibitors / Myocarditis / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Curr Oncol Rep Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: S11912-021-01070-6