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04.05.2021 | COVID-19 | Cardio-oncology (EH Yang, Section Editor) Zur Zeit gratis

Cardiotoxicity of Immune Checkpoint Inhibitors

verfasst von: Rushin P. Patel, Rohan Parikh, Krishna S. Gunturu, Rana Zouveenoor Tariq, Sourbha S. Dani, Sarju Ganatra, Anju Nohria

Erschienen in: Current Oncology Reports | Ausgabe 7/2021

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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.

Summary

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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Titel: Cardiotoxicity of Immune Checkpoint Inhibitors
verfasst von: Rushin P. Patel
Rohan Parikh
Krishna S. Gunturu
Rana Zouveenoor Tariq
Sourbha S. Dani
Sarju Ganatra
Anju Nohria
Publikationsdatum: 04.05.2021
Verlag: Springer US
Schlagwort: COVID-19
Erschienen in: Current Oncology Reports / Ausgabe 7/2021
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI: https://doi.org/10.1007/s11912-021-01070-6

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Cardiotoxicity of Immune Checkpoint Inhibitors