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Erschienen in: Current Treatment Options in Cardiovascular Medicine 12/2020

04.11.2020 | Cardio-oncology (M Fradley, Section Editor)

Cardiotoxicity of Contemporary Anticancer Immunotherapy

verfasst von: Natalie Dal’bo, MD, Rushin Patel, MD, Rohan Parikh, MD, Sachin P. Shah, MD, Avirup Guha, MD, Sourbha S. Dani, MD, Sarju Ganatra, MD

Erschienen in: Current Treatment Options in Cardiovascular Medicine | Ausgabe 12/2020

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Abstract

Purpose of review

Contemporary anticancer immunotherapy, particularly immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell therapy, has changed the landscape of treatment for patients with a variety of malignancies who historically had a poor prognosis. However, both immune checkpoint inhibitors and CAR T cell therapy are associated with serious cardiovascular adverse effects. As immunotherapy evolves to include high-risk patients with preexisting cardiovascular risk factors and disease, the risk and relevance of its associated cardiotoxicity will be even higher.

Recent findings

ICI can cause myocarditis, which usually occurs early after initiation, can be fulminant, and prompt treatment with high-dose corticosteroids is crucial. CAR T cell therapy frequently leads to cytokine release syndrome, which is associated with cardiomyopathy or arrhythmia development and may also result in circulatory collapse. Supportive treatment, as well as tocilizumab, an anti-interleukin-6 receptor antibody, is the cornerstone of treatment. Recent findings suggest that preexisting cardiovascular risk factors and disease may increase the risk of such cardiotoxicity, and prompt recognition, as well as treatment, may favorably alter the outcomes.

Summary

ICI and CAR T cell therapy have improved cancer-related outcomes; however, they both are associated with potentially therapy-limiting cardiotoxicity. Cardio-oncologists are required to play an important role in patient selection, pretherapy cardiovascular optimization, and prompt recognition and treatment of cardiotoxicity.
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Metadaten
Titel
Cardiotoxicity of Contemporary Anticancer Immunotherapy
verfasst von
Natalie Dal’bo, MD
Rushin Patel, MD
Rohan Parikh, MD
Sachin P. Shah, MD
Avirup Guha, MD
Sourbha S. Dani, MD
Sarju Ganatra, MD
Publikationsdatum
04.11.2020
Verlag
Springer US
Erschienen in
Current Treatment Options in Cardiovascular Medicine / Ausgabe 12/2020
Print ISSN: 1092-8464
Elektronische ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-020-00867-1

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