• Remo Poto, Giancarlo Marone, Flora Pirozzi, Maria Rosaria Galdiero, Alessandra Cuomo, Luigi Formisano, Roberto Bianco, Carminia Maria Della Corte, Floriana Morgillo, Stefania Napolitano, Teresa Troiani, Carlo G Tocchetti, Valentina Mercurio, and Gilda Varricchi.
• Department of Translational Medical Sciences, Federico II University, Naples, Italy.
• Expert Opin Drug Saf. 2021 Jun 1; 20 (6): 685-694.

AbstractIntroduction: Cancer immunotherapies with monoclonal antibodies (mAbs) against immune checkpoints (i.e. CTLA-4 and PD-1/PD-L1) have revolutionized antineoplastic treatments. Immune checkpoint inhibitors (ICIs) approved for cancer immunotherapy are mAbs anti-CTLA-4 (ipilimumab), anti-PD-1 (nivolumab, pembrolizumab, and cemiplimab), and anti-PD-L1 (atezolizumab, avelumab, and durvalumab). Treatment with ICIs can be associated with immune-related adverse events (irAEs), including an increased risk of developing myocarditis. These findings are compatible with the observation that, CTLA-4, PD-1, and PD-L1 pathways play a central role in the modulation of autoimmunity.Areas covered: In this paper, we start from examining the pathogenesis of cardiovascular adverse events from ICIs, and then we focus on risk factors and strategies to prevent and manage this cardiotoxicity.Expert opinion: There is a growing need for a multidisciplinary approach of ICI-associated cardiotoxicity, involving oncologists, cardiologists, and immunologists. Prevention and effective management of ICIs cardiotoxicity starts with an in-depth screening and surveillance strategies of high-risk patients, in order to improve early detection and appropriate management in a personalized approach.

24 keywords...

hide…