The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.
Acute heart failure due to autoimmune myocarditis under pembrolizumab treatment for metastatic melanoma
Open accessAbstract
Antibodies that stimulate the immune system by targeting inhibitory T cell receptors were successfully introduced into oncological practice and are capable to overcome tumor-induced immune evasion. In particular, targeting of the inhibitory receptors CTLA-4 and PD-1 or its ligand PD-L1 have been shown to be beneficial for patients with melanoma, renal cell cancer, non-small cell lung cancer and a growing list of other cancers with impressive response rates. Here, we report a severe, potentially life-threatening side effect of anti-PD-1 immunotherapy with pembrolizumab, which has not been previously described in the literature. A 73-year-old woman with metastatic uveal melanoma treated with pembrolizumab in third line developed severe heart failure due to pembrolizumab-mediated autoimmune myocarditis. Echocardiographic studies revealed a severely impaired left ventricular function with dyssynchrony. All tests for cardiotropic viruses were negative and histological analysis of a myocardial biopsy showed lymphocytic infiltration with a predominance of CD8 positive cells and a reduction of FOXP3 positive regulatory T cells. After initiation of corticosteroids and guideline-conform heart failure therapy, the symptoms rapidly improved and the left ventricular function recovered. While autoimmune myocarditis is a documented side effect of other checkpoint inhibitors, as for example ipilimumab and in one case with anti-PD-L1 antibody, it is not described for anti-PD-1-antibodies like pembrolizumab or nivolumab. As the FDA recently approved both pembrolizumab and nivolumab for melanoma progressing after anti-CTLA-4 treatment with ipilimumab, more patients will soon receive anti-PD-1 therapy. Thus, it is important to be aware of such rare, but severe immune-related adverse events.
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Cites
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Cited by
Brahmer, J. R., Lacchetti, C., Schneider, B. J., Atkins, M. B., Brassil, K. J., Caterino, J. M., Chau, I., Ernstoff, M. S., Gardner, J. M., Ginex, P., et al. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.2017.77.6385 · Cited by 3,713
Haanen, J. B. A. G., Carbonnel, F., Robert, C., Kerr, K. M., Peters, S., Larkin, J., & Jordan, K. (2017) · Annals of Oncology · doi:10.1093/annonc/mdx225 · Cited by 2,367
Fulminant Myocarditis with Combination Immune Checkpoint Blockade
Johnson, D. B., Balko, J. M., Compton, M. L., Chalkias, S., Gorham, J., Xu, Y., Hicks, M., Puzanov, I., Alexander, M. R., Bloomer, T. L., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1609214 · Cited by 2,308
Myocarditis in Patients Treated With Immune Checkpoint Inhibitors
Mahmood, S. S., Fradley, M. G., Cohen, J. V., Nohria, A., Reynolds, K. L., Heinzerling, L. M., Sullivan, R. J., Damrongwatanasuk, R., Chen, C. L., Gupta, D., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.02.037 · Cited by 1,608
Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper
Champiat, S., Lambotte, O., Barreau, E., Belkhir, R., Berdelou, A., Carbonnel, F., Cauquil, C., Chanson, P., Collins, M., Durrbach, A., et al. (2016) · Annals of Oncology · doi:10.1093/annonc/mdv623 · Cited by 903
Metadata
- Authors
- Läubli, H., Balmelli, C., Bossard, M., Pfister, O., Glatz, K., & Zippelius, A.
- Venue
- Journal for ImmunoTherapy of Cancer
- Publisher
- BMJ
- Published
- 2015-04-21
- Volume
- 3
- Issue
- 1
- Pages
- 11-11
- ISSN
- 2051-1426 (ISSN-L)
- OpenAlex
- W1992987036
- Cited by
- 319
- References
- 11
- FWCI
- 15.21
- Type
- journal article
- Language
- en
- Open access
- gold
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- Läubli, H., Balmelli, C., Bossard, M., Pfister, O., Glatz, K., & Zippelius, A. (2015). Acute heart failure due to autoimmune myocarditis under pembrolizumab treatment for metastatic melanoma. Journal for ImmunoTherapy of Cancer. https://doi.org/10.1186/s40425-015-0057-1
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
