Immune checkpoint inhibitor myocarditis

Abstract

Purpose of review: The purpose of this study is to summarize and highlight the recent literature regarding immune checkpoint inhibitor myocarditis.

Recent findings: The use of immune checkpoint inhibitors, a promising form of immunotherapy, is rapidly increasing in oncology. These drugs have been recently found to cause a fulminant myocarditis associated with a high-case fatality rate. Most patients present early in the course of treatment with positive cardiac biomarkers. Endomyocardial biopsy findings resemble high-grade cardiac transplant rejection. Treatment requires cessation of immunotherapy, aggressive immunosuppression, and hemodynamic stabilization.

Summary: Immune checkpoint inhibitor myocarditis is a newly described entity. Although relatively uncommon compared with other immune-related adverse events associated with these drugs, it is associated with the highest rate of mortality.