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Cardiovascular Toxicities Associated with Cancer Immunotherapies

  • Daniel Y. Wang
  • Gosife Donald Okoye
  • Thomas G. Neilan
  • Douglas B. JohnsonEmail author
  • Javid J. Moslehi
Cardio-Oncology (SA Francis, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardio-Oncology

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.

Summary

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

Immune therapy Checkpoint inhibitors PD-1 CTLA-4 Cardiovascular toxicities Myocarditis 

Notes

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

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Daniel Y. Wang
    • 1
  • Gosife Donald Okoye
    • 2
    • 3
  • Thomas G. Neilan
    • 4
    • 5
  • Douglas B. Johnson
    • 1
    Email author
  • Javid J. Moslehi
    • 1
    • 2
    • 3
  1. 1.Divisions of Oncology, Department of MedicineVanderbilt University Medical CenterNashvilleUSA
  2. 2.Department of Medicine, Cardiovascular MedicineVanderbilt University Medical CenterNashvilleUSA
  3. 3.Department of Medicine, Cardio-Oncology ProgramVanderbilt University Medical CenterNashvilleUSA
  4. 4.Division of Cardiovascular Medicine, Department of MedicineMassachusetts General HospitalBostonUSA
  5. 5.Department of Medicine, Cardio-Oncology ProgramMassachusetts General HospitalBostonUSA

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