Successful use of equine anti-thymocyte globulin (ATGAM) for fulminant myocarditis secondary to nivolumab therapy
Open accessAbstract
BACKGROUND: Immune-mediated myocarditis is an uncommon adverse effect of immune checkpoint inhibition and is associated with a high rate of mortality. METHODS: In this reported case, a 64-year-old woman with right temporo-parietal glioblastoma IDH-WT was treated with nivolumab, temozolomide and radiation therapy on a clinical trial. She developed malignant arrhythmias secondary to histologically confirmed severe immune-mediated myocarditis. She was treated with equine anti-thymocyte globulin (ATGAM) due to development of malignant arrhythmias refractory to high-dose corticosteroids. RESULTS: This report describes the only case of immune-mediated myocarditis treated with ATGAM resulting in a favourable outcome. CONCLUSIONS: Use of ATGAM should be considered in cases of steroid-refractory immune-mediated myocarditis and administered in close consultation with a cardiac transplant team experienced in the use of this agent.
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ICI myocarditis may occur following ICI treatment in patients with cancer.
“one of the best examples of drug-induced lymphocytic myocarditis is ICI myocarditis, which may occur following ICI treatment in patients with cancer.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [119]
T cells may play a role in driving the pathogenesis of ICI myocarditis.
“suggesting a potential role of T cells in driving the pathogenesis of this condition.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [119]
Cardiac biopsies from patients with ICI myocarditis reveal myocardial infiltration primarily by T cells.
“Cardiac biopsies from patients with ICI myocarditis revealed myocardial infiltration primarily by T cells”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [119]
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- Authors
- Tay, R. Y., Blackley, E., McLean, C., Moore, M., Bergin, P., Gill, S., & Haydon, A.
- Affiliations
- The Alfred Hospital (AU)
- Corresponding author
- Haydon, Andrew
- Venue
- British Journal of Cancer
- Published
- 2017-08-10
- Volume
- 117
- Issue
- 7
- Pages
- 921-924
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC5625667
- OpenAlex
- W2743727543
- Cited by
- 119
- References
- 3
- Citations by year
- 2026: 14 · 2025: 7 · 2024: 15 · 2023: 11 · 2022: 12 · 2021: 21 · 2020: 16 · 2019: 12 · 2018: 8 · 2017: 2
- FWCI
- 4.58
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-sa)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
- Keywords
- ATGAM, immune-mediated myocarditis, fulminant myocarditis, nivolumab, immune checkpoint inhibitors, immune-related adverse events, malignant arrhythmias, glioblastoma, immunotherapy cardiotoxicity
- MeSH terms
- Temozolomide, Nivolumab, Animals, Antibodies, Monoclonal, Antilymphocyte Serum, Antineoplastic Combined Chemotherapy Protocols, Brain Neoplasms, Dacarbazine, Female, Glioblastoma, Horses, Humans, Middle Aged, Myocarditis, Chemoradiotherapy
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