Some cancer immunotherapies may increase the risk of myocarditis

Some immune checkpoint inhibitors (ICIs) may cause serious cardiotoxicities, including myocarditis, according to new data published in Circulation.

The study's authored noted that has been difficult to define the clinical features of ICI-related myocarditis (ICI-myocarditis). Could their findings be a step forward?

The group established an international registry with data from 49 different institutions in 11 countries, focusing on 125 reported cases of ICI-myocarditis that included electrocardiogram (ECG) findings. The ICIs involved in these cases were primarily ipilimumab, nivolumab and pembrolizumab.

Two cardiologists analyzed each ECG while blinded to the individual case and outcomes, confirming that ICI-myocarditis "is highly arrhythmogenic." Patients were diagnosed with a wide range of ECG abnormalities, including conduction blocks, decreased voltage, and repolarization abnormalities.

 

“ICI-myocarditis is still poorly understood, but patients and physicians need to be aware of the adverse impact ICIs may have on some patients’ hearts,” Javid Moslehi, MD, William Grossman Distinguished Professor and Section Chief of Cardio-Oncology and Immunology for the University of California San Francisco Heart and Vascular Center, said in a press release. “Further studies are needed to evaluate how ECG changes in patients treated with ICIs can inform prediction and monitoring strategies for ICI-myocarditis.”

Moslehi also emphasized the difference it makes when researchers work with one another to examine a challenging problem. 

“This study really exemplifies the power of teamwork," he added. "We have formed a true international network with cardiologists and cardio-oncologists from around the world."

Read the full study here.

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