Immune checkpoint inhibitors and cardiovascular toxicity
Open accessAbstract
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.
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ICI myocarditis is an infrequent but potentially fatal condition associated with ICI therapies, especially when used in combination.
“ICI myocarditis emerges as an infrequent but potentially fatal condition associated with ICI therapies, especially when used in combination”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [43]
The discovery of α-MyHC-specific T cells in ICI myocarditis suggests potential involvement of autoreactive T cells targeting α-MyHC in the initiation and progression of other forms of myocarditis.
“This discovery suggests a potential involvement of autoreactive T cells targeting α -MyHC in the initiation and progression of other forms of myocarditis.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [43]
Recent cases of ICI myocarditis have expanded insights into the role of α-MyHC-specific T cells in myocarditis development.
“Recent cases of ICI myocarditis have expanded our insights into the role of α -MyHC-specific T cells in myocarditis development. 41-46”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [43]
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Self-citation
- Authors
- Lyon, A. R., Yousaf, N., Battisti, N. M. L., Moslehi, J., & Larkin, J.
- Affiliations
- Royal Brompton Hospital (GB)
- Royal Marsden NHS Foundation Trust (GB)
- Vanderbilt University (US)
- Corresponding author
- Lyon, Alexander R
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 19
- Issue
- 9
- Pages
- e447-e458
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2888880602
- Cited by
- 575
- References
- 10
- Citations by year
- 2026: 48 · 2025: 64 · 2024: 80 · 2023: 82 · 2022: 87 · 2021: 87 · 2020: 86 · 2019: 39 · 2018: 1
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by-nc-nd)
- Funders
- NIHR Cambridge Biomedical Research Centre
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
- Keywords
- immune checkpoint inhibitors, cardiotoxicity, immune-related adverse events, inflammatory cardiomyopathy, biomarkers, electrocardiogram, cardiac imaging, endomyocardial biopsy, risk factors, pathophysiology, clinical management, surveillance strategy, T cell immunity
- MeSH terms
- Antineoplastic Agents, Immunological, Heart, Heart Diseases, Humans, Neoplasms, Risk Factors, Treatment Outcome, Risk Assessment, Cardiotoxicity
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