• Internal medicine · Oct 2022

    Case Reports

    An Autopsy Case of Late-onset Fulminant Myocarditis Induced by Nivolumab in Gastric Cancer.

    • Ken Naganuma, Yosuke Horita, Keisuke Matsuo, Yu Miyama, Yoshiaki Mihara, Masanori Yasuda, Shintaro Nakano, and Tetsuya Hamaguchi.
    • Department of Medical Oncology, Saitama Medical University International Medical Center, Japan.
    • Intern. Med. 2022 Oct 1; 61 (19): 2867-2871.

    AbstractNivolumab is an immune-checkpoint inhibitor (ICI) that can induce unique treatment-related toxicities, such as immune-related adverse events (irAEs). Myocarditis is a serious irAE with an incidence between 0.06% and 1.14%. Although the peak onset of irAE is generally within three months from the start of treatment, we experienced an autopsy case of late-onset fulminant myocarditis caused by nivolumab in Epstein Barr virus-associated gastric cancer. Pathological complete remission of the primary lesion was confirmed by the autopsy. We should consider possible complications of cardiac irAEs, especially fulminant myocarditis, even beyond three months after starting ICI therapy.

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