Immune checkpoint inhibitors and cardiovascular toxicity. Issue 9 (September 2018)

• Record Type: Journal Article
• Authors: Lyon, Alexander R; Yousaf, Nadia; Battisti, Nicolò M L; Moslehi, Javid; Larkin, James
• Is Part Of: Lancet oncology. Volume 19:Issue 9(2018)
• Page Start: e447
• Page End: e458
• Publication Date: 2018-09
• Subjects: Oncology -- Periodicals; Neoplasms -- Periodicals; Cancérologie -- Périodiques; Oncologie; Oncology; Periodicals; Electronic journals; 616.994005
• DOI: 10.1016/S1470-2045(18)30457-1
• Languages: English
• ISSNs: 1470-2045

Abstract

Summary: Immune checkpoint inhibitors are a new class of anticancer therapies that amplify T-cell-mediated immune responses against cancer cells. Immune checkpoint inhibitors have shown important benefits in phase 3 trials, and several agents have been approved for specific malignancies. Although adverse events from immune checkpoint inhibitors are a common occurrence, cardiotoxic effects are uncommon, but are often serious complications with a relatively high mortality. Most cardiotoxic effects appear to be inflammatory in nature. Clinical assessment of a combination of biomarkers, electrocardiography, cardiac imaging, and endomyocardial biopsy can be used to confirm a possible diagnosis. In this Review, we discuss the epidemiology of immune checkpoint inhibitor-mediated cardiotoxic effects, as well as their clinical presentation, subtypes, risk factors, pathophysiology, and clinical management, including the introduction of a new surveillance strategy.