Acute autoimmune myocarditis and hepatitis due to ipilimumab monotherapy for malignant melanoma. (June 2019)

• Record Type: Journal Article
• Authors: Samara, Yazeed; Yu, Chun Lai; Dasanu, Constantin A
• Is Part Of: Journal of oncology pharmacy practice. Volume 25:Number 4(2019)
• Page Start: 966
• Page End: 968
• Publication Date: 2019-06
• Subjects: Ipilimumab -- autoimmunity -- myocarditis -- heart failure -- autoimmune hepatitis; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155218755868
• Languages: English
• ISSNs: 1078-1552

Abstract

An important agent in melanoma therapy, ipilimumab is associated with autoimmune toxicity. Two cases of autoimmune pericarditis and large pericardial effusion have been documented with its use. Reports of myocardial toxicity have surfaced with this agent, mainly when used in combination with PD1 blockade. We present herein a case of autoimmune myocarditis leading to biventricular failure after four doses of IV ipilimumab 3 mg/kg as a single agent. Furthermore, this toxic effect may be anticipated with PD1 inhibitors. Increased clinical suspicion, prompt diagnosis, and steroid therapy are crucial to ensure a favorable clinical outcome.