Practical cardiovascular imaging approach to diagnose immune checkpoint inhibitor myocarditis

Eur Heart J Cardiovasc Imaging. 2021 Mar 22;22(4):372-374. doi: 10.1093/ehjci/jeaa340.

Abstract

Immuno-oncology employs various therapeutic strategies that harness a patient's own immune system to fight disease and has been a promising new strategy for cancer therapy over the last decade. Immune checkpoint inhibitors (ICI), are monoclonal antibodies, that increase antitumor immunity by blocking intrinsic down-regulators of immunity, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1) or its ligand, programmed cell death ligand 1 (PD-L1). Seven ICIs are currently approved by the Food and Drug Administration and have increased the overall survival for patients with various cancer subtypes. These are used either as single agents or in combination with other checkpoint inhibitors, small molecular kinase inhibitors or cytotoxic chemotherapies. There are also many other immune modifying agents including other checkpoint inhibitor antibodies that are under investigation in clinical trials.

Keywords: cardiac MRI; checkpoint inhibitors; immunotherapy; myocarditis; troponin.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors
  • Lung Neoplasms* / drug therapy
  • Myocarditis* / diagnostic imaging
  • Neoplasms* / diagnostic imaging
  • Neoplasms* / drug therapy
  • Programmed Cell Death 1 Receptor / therapeutic use

Substances

  • Immune Checkpoint Inhibitors
  • Programmed Cell Death 1 Receptor