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      Cardiovascular Toxicity of Immune Checkpoint Inhibitors: Clinical Risk Factors

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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.

          Summary

          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.

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          Most cited references62

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          Cancer immunotherapy using checkpoint blockade

          Jedd Wolchok, Antoni Ribas (2018)
          The release of negative regulators of immune activation (immune checkpoints) that limit antitumor responses has resulted in unprecedented rates of long-lasting tumor responses in patients with a variety of cancers. This can be achieved by antibodies blocking the cytotoxic T lymphocyte antigen-4 (CTLA-4) or the programmed death-1 (PD-1) pathway, either alone or in combination. The main premise for inducing an immune response is the pre-existence of antitumor T cells that were limited by specific immune checkpoints. Most patients who have tumor responses maintain long lasting disease control, yet one third of patients relapse. Mechanisms of acquired resistance are currently poorly understood, but evidence points to alterations that converge on the antigen presentation and interferon gamma signaling pathways. New generation combinatorial therapies may overcome resistance mechanisms to immune checkpoint therapy.
          Article 0 comments Cited 1970 times – based on 0 reviews     Review now
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            Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma

            James Larkin, Vanna Chiarion-Sileni, Rene Gonzalez … (2015)
            New England Journal of Medicine, 373(1), 23-34
            Article 0 comments Cited 1572 times – based on 0 reviews     Review now
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              Immune-Related Adverse Events Associated with Immune Checkpoint Blockade

              Dan L Longo, Michael A. Postow, Robert Sidlow … (2018)
              Article 0 comments Cited 1303 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Carlo Gabriele Tocchetti:
                ORCID: http://orcid.org/0000-0001-5983-688X
                carlogabriele.tocchetti@unina.it
                Journal
                Journal ID (nlm-ta): Curr Oncol Rep
                Journal ID (iso-abbrev): Curr Oncol Rep
                Title: Current Oncology Reports
                Publisher: Springer US (New York )
                ISSN (Print): 1523-3790
                ISSN (Electronic): 1534-6269
                Publication date (Electronic): 7 January 2021
                Publication date (Print): 2021
                Volume: 23
                Issue: 2
                Electronic Location Identifier: 13
                Affiliations
                [1 ]GRID grid.4691.a, ISNI 0000 0001 0790 385X, Department of Translational Medical Sciences, , Federico II University, ; Naples, Italy
                [2 ]GRID grid.4691.a, ISNI 0000 0001 0790 385X, Center for Basic and Clinical Immunology Research, , Federico II University, ; Naples, Italy
                [3 ]GRID grid.4691.a, ISNI 0000 0001 0790 385X, World Allergy Organization Center of Excellence, , Federico II University, ; Naples, Italy
                [4 ]GRID grid.4691.a, ISNI 0000 0001 0790 385X, Interdepartmental Center for Clinical and Translational Research (CIRCET), , Federico II University, ; Naples, Italy
                Author information
                http://orcid.org/0000-0001-5983-688X
                Article
                Publisher ID: 1002
                DOI: 10.1007/s11912-020-01002-w
                PMC ID: 7790474
                PubMed ID: 33415405
                SO-VID: ced7fe0f-db56-427c-b482-0d7db0c49283
                Copyright © © The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date accepted : 17 December 2020
                Categories
                Subject: Immuno-oncology (RM Bukowski and JH Finke, Section Editors)
                Custom metadata
                issue-copyright-statement © Springer Science+Business Media, LLC, part of Springer Nature 2021

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: immune checkpoint inhibitors,cardio-immuno-oncology,cardiotoxicity,risk factors
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: immune checkpoint inhibitors, cardio-immuno-oncology, cardiotoxicity, risk factors

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