Tag Archives: cardiotoxicity

Introduction Immune checkpoint inhibitors (ICIs) have revolutionised outcomes in a number of advanced cancers. The median life-expectancy for patients with metastatic melanoma was nine months prior to the introduction of ICIs in 2011.1 One-year survival is now over 70%, and over half of patients are still alive at three years,2 with multiple phase II and III trials demonstrating durable responses in a range of tumour types.3 ICIs are antibodies that block the cytotoxic T-cell regulators lymphocyte-associated protein-4 (CTLA-4; ipilimumab), programmed cell death protein-1 (PD-1; nivolumab, pembrolizumab and cemiplimab) or the PD-1 ligand (ate

As discussed by Findlay and colleagues, ICI-related myocarditis is rare but potentially fatal. Its true incidence remains unknown but data from a single cancer registry study from the USA suggests a prevalence of 1.14% with fatality rates as high as 50%.4,5 Data suggest that myocarditis is an early ICI-toxicity, typically seen within the first three months of starting treatment, and is more common in patients treated with combination anti-CTLA-4 and anti-PD1 blockade. The prevalence of myocarditis in patients treated with chemotherapy and anti-PD1 or tyrosine kinase Inhibitors (TKI) and anti-PD1 combinations has not been described. Identifyin

Cardiotoxicity and adjuvant anthracycline in early breast cancer Anthracycline-based polychemotherapy regimens for early-stage breast cancer have demonstrated a superior disease-free and overall survival in comparison to non-anthracycline based regimens.6 The increasing usage and efficacy of adjuvant chemotherapy is a significant factor contributing to the fall in mortality from breast cancer.6-9 However, the rising numbers of patients treated with anthracyclines in the adjuvant setting could mean that many women have sustained subclinical cardiac damage that is not yet clinically apparent. A recent analysis has attempted to define the exten

(more…)