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Review
. 2017 Mar;19(3):21.
doi: 10.1007/s11886-017-0835-0.

Cardiovascular Toxicities Associated with Cancer Immunotherapies

Daniel Y Wang  1 , Gosife Donald Okoye  2   3 , Thomas G Neilan  4   5 , Douglas B Johnson  6 , Javid J Moslehi  1   2   3
Affiliations
Review

Cardiovascular Toxicities Associated with Cancer Immunotherapies

Daniel Y Wang et al. Curr Cardiol Rep. 2017 Mar.

Abstract

Purpose of review: We review the cardiovascular toxicities associated with cancer immune therapies and discuss the cardiac manifestations, potential mechanisms, and management strategies.

Recent findings: The recent advances in cancer immune therapy with immune checkpoint inhibitors and adoptive cell transfer have improved clinical outcomes in numerous cancers. The rising use of cancer immune therapy will lead to a higher incidence in immune-related adverse events. Recent studies have highlighted several reports of severe cases of acute cardiotoxic events with immune therapy including fulminant myocarditis. We believe that immune-mediated myocarditis is a driving mechanism behind these cardiovascular toxicities and requires vigilant screening and prompt management with corticosteroids and immune-modulating drugs, especially with combination immune therapies. While the incidence of serious cardiovascular toxicities with immune therapy appears low, these can be life-threatening especially when manifesting as acute immune-mediated myocarditis. Further collaborative studies are needed to effectively identify, characterize, and manage these events.

Keywords: CTLA-4; Cardiovascular toxicities; Checkpoint inhibitors; Immune therapy; Myocarditis; PD-1.

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Conflict of interest statement

Compliance with Ethical Standards

Conflict of Interest Daniel Y. Wang, Gosife Donald Okoye, and Thomas G. Neilan declare that they have no conflict of interest.

Douglas B. Johnson reports being on the advisory board for BMS and Genoptix, and grants from Incyte.

Javid J. Moslehi reports personal fees from Pfizer, Novartis, Bristol-Myers Squibb, Takeda, Ariad, Vertex, Acceleron, Incyte, Verastem, RGenix, StemCentRx, Heat Biologics, and Pharmacyclics

Figures

Fig. 1
Fig. 1
Timeline of breakthroughs in cancer immune therapy
Fig. 2
Fig. 2
Mechanism of checkpoint inhibition in a lymphatic tissue and b peripheral tissue
Fig. 3
Fig. 3
Proposed mechanism for management of immune-mediated myocarditis
See this image and copyright information in PMC

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