Cardiovascular Toxicity of Immune Checkpoint Inhibitors: Clinical Risk Factors

Curr Oncol Rep. 2021 Jan 7;23(2):13. doi: 10.1007/s11912-020-01002-w.

Abstract

Purpose of review: Immune checkpoint inhibitors, such as monoclonal antibodies targeting CTLA-4, PD-1, and PD-L1, have improved the outcome of many malignancies, but serious immune-related cardiovascular adverse events have been observed. Patients' risk factors for these toxicities are currently being investigated.

Recent findings: Interfering with the CTLA-4 and PD-1 axes can bring to several immune-related adverse events, including cardiotoxic events such as autoimmune myocarditis, pericarditis, and vasculitis, suggesting that these molecules play an important role in preventing autoimmunity. Risk factors (such as pre-existing cardiovascular conditions, previous and concomitant cardiotoxic treatments, underlying autoimmune diseases, tumor-related factors, simultaneous immune-related toxic effects, and genetic factors) should be always recognized for the correct management of these toxicities.

Keywords: Cardio-immuno-oncology; Cardiotoxicity; Immune checkpoint inhibitors; Risk factors.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use
  • B7-H1 Antigen
  • CTLA-4 Antigen
  • Cardiotoxicity / etiology*
  • Cell Cycle Checkpoints / drug effects*
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immunotherapy / adverse effects*
  • Neoplasms / drug therapy
  • Risk Factors

Substances

  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • CD274 protein, human
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Immune Checkpoint Inhibitors