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Review
. 2024 Feb 28:14:1347140.
doi: 10.3389/fonc.2024.1347140. eCollection 2024.

Immunotherapy-associated cardiovascular toxicities: insights from preclinical and clinical studies

Youqian Kong  1 , Xiaoyu Wang  1 , Rui Qie  2
Affiliations
Review

Immunotherapy-associated cardiovascular toxicities: insights from preclinical and clinical studies

Youqian Kong et al. Front Oncol. .

Abstract

Immune checkpoint inhibitors (ICIs) have become a widely accepted and effective treatment for various types of solid tumors. Recent studies suggest that cardiovascular immune-related adverse events (irAEs) specifically have an incidence rate ranging from 1.14% to more than 5%. Myocarditis is the most common observed cardiovascular irAE. Others include arrhythmias, pericardial diseases, vasculitis, and a condition resembling takotsubo cardiomyopathy. Programmed cell death-1 (PD-1)/programmed cell death ligand-1 (PD-L1) pathway, cytotoxic T-lymphocyte antigen-4 (CTLA-4) pathway, and the recently discovered lymphocyte-activation gene 3 (LAG-3) pathway, play a critical role in boosting the body's natural immune response against cancer cells. While ICIs offer significant benefits in terms of augmenting immune function, they can also give rise to unwanted inflammatory side effects known as irAEs. The occurrence of irAEs can vary in severity, ranging from mild to severe, and can impact the overall clinical efficacy of these agents. This review aims to summarize the underlying mechanisms of cardiovascular irAE from both preclinical and clinical studies for a better understanding of cardiovascular irAE in clinical application.

Keywords: cardio-oncology; clinical studies; immune checkpoint inhibitors; immune-related adverse events; preclinical studies.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of immune checkpoint inhibitors.
Figure 2
Figure 2
Types of cardiotoxicity induced by immune checkpoint inhibitors.
Figure 3
Figure 3
The mechanisms of immune checkpoint inhibitors-induced cardiotoxicity.
See this image and copyright information in PMC

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