PodCast 🎧: Cardiotoxicity associated with Immune Check Point Inhibitors

Immune Check Point Inhibitors that  have been approved by FDA, include

• PD-1 (programmed cell death-protein 1) inhibitors (anti PD-1 antibodies: nivolumab, pembrolizumab, cemiplimab), 
• PD-L1 (programmed cell death-ligand 1) inhibitors (anti PD-L1 antibodies: atezolizumab, avelumab, durvalumab), and 
• CTLA-4 (cytotoxic T-lymphocyte–associated antigen 4) inhibitors (anti CTLA-4 antibodies: ipilimumab)

Increasingly, Immune Check Point Inhibitors are being either combined (eg, use of ipilimumab plus nivolumab) or combined with other cancer therapies in ongoing clinical trials. 

1. Dyspnea With Checkpoint Inhibition: A Kaleidoscope of Issues  Joshua Mitchell, MD, FACC; Daniel J. Lenihan, MD, FACC www.acc.org
2. Emerging Concerns in Cardio-Oncology: Immune Checkpoint Inhibitor Cardiotoxicity Dinu-Valentin Balanescu, MD; Teodora Donisan, MD; Nicolas L. Palaskas, MD, FACC; Cezar Iliescu, MD, FACC www.acc.org
3. Myocarditis in the Setting of Cancer Therapeutics: Proposed Case Definitions for Emerging Clinical Syndromes in Cardio-Oncology Marc Bonaca, MD, Javid Moselehi et al Circulation 2019;140: 80-91
4. Fulminant Myocarditis with Combination Immune Checkpoint Blockade Johnson DB et al N Engl J Med 2016; 375:1749-1755
5. Abatacept for Severe Immune Checkpoint Inhibitor–Associated Myocarditis Salem JE, Allenbach Y, Vozy A, Brechot N, Johnson DB, Moslehi JJ, Kerneis M. N Engl J Med 2019; 380:2377-2379
6. Alemtuzumab for Immune-Related Myocarditis Due to PD-1 Therapy Esfahani K, Buhlaiga N, Thébault P, Lapointe R, Johnson NA, Miller WH Jr. N Engl J Med 2019; 380:2375-2376
7. Myocarditis In Patients Treated With Immune Checkpoint Inhibitors Syed S. Mahmood, Michael G. Fradley, Justine V. Cohen, Anju Nohria, Kerry L. Reynolds, Lucie M. Heinzerling, Ryan J. Sullivan, Rongras Damrongwatanasuk, Carol L. Chen, Dipti Gupta, Michael C. Kirchberger, Magid Awadalla, Malek Z.O. Hassan, Javid J. Moslehi, Sachin P. Shah, Sarju Ganatra, Paaladinesh Thavendiranathan, Donald P. Lawrence, John D. Groarke, Tomas G. Neilan JACC April 24, 2018, 71 (16) 1755-1764