Cardiovascular toxicities associated with immune checkpoint inhibitors

2019/01/25 by Jiun-Ruey Hu, Jiun‐Ruey Hu, Roberta Florido +14 · 510 citations
Medicine · #Arteritis #CAR-T cell therapy research #Cancer Immunotherapy and Biomarkers #Disease #Immune system #Immunology #Internal medicine #Medicine #Myocarditis #Myositis #Peptidase Inhibition and Analysis #Vasculitis

paper · pdf · doi:10.1093/cvr/cvz026

published in Cardiovascular Research 115(5), 854-868 (Oxford University Press)

openalex publication_date 2019/01/25 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/04

Abstract

Cardiovascular toxicities associated with immune checkpoint inhibitors (ICIs) have been reported in case series but have been underappreciated due to their recent emergence, difficulties in diagnosis and non-specific clinical manifestations. ICIs are antibodies that block negative regulators of the T cell immune response, including cytotoxic T lymphocyte-associated protein-4 (CTLA-4), programmed cell death protein-1 (PD-1), and PD-1 ligand (PD-L1). While ICIs have introduced a significant mortality benefit in several cancer types, the augmented immune response has led to a range of immune-related toxicities, including cardiovascular toxicity. ICI-associated myocarditis often presents with arrhythmias, may co-exist with myositis and myasthenia gravis, can be severe, and portends a poor prognosis. In addition, pericardial disease, vasculitis, including temporal arteritis, and non-inflammatory heart failure, have been recently described as immune-related toxicities from ICI. This narrative review describes the epidemiology, diagnosis, pathophysiology, and treatment of cardiovascular toxicities of ICI therapy, highlighting recent developments in the field in the past year.

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