Immune checkpoint inhibitors-associated pericardial disease: a systematic review of case reports.
Cardiac tamponade
Cardiotoxicity
Immune checkpoint inhibitors
Pericardial effusion
Pericarditis
Rechallenge
Journal
Cancer immunology, immunotherapy : CII
ISSN: 1432-0851
Titre abrégé: Cancer Immunol Immunother
Pays: Germany
ID NLM: 8605732
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
29
12
2020
accepted:
07
04
2021
pubmed:
21
4
2021
medline:
30
9
2021
entrez:
20
4
2021
Statut:
ppublish
Résumé
Treatment with immune checkpoint inhibitors (ICIs) can be complicated by cardiovascular toxicity, including pericardial disease. To date, no prospective studies specifically investigated the optimal treatment of ICI-associated pericardial disease, and the available evidence is based on case reports and series only. We performed a systematic review of case reports and series including 20 publications for a total of 28 cases of ICI-associated pericardial disease. In this review, pericardial disease was reversible in the majority of cases (75%), although 2 deaths were reported. The majority of cases were life-threatening (G4, 53.6%) or severe (G3, 21.4%), requiring pericardiocentesis. Higher rates of improvement were associated with administration of corticosteroids (86.7% vs 61.5%), presence of other immune-related adverse events (90.9% vs. 64.7%), and non-malignant effusions (86.7% vs 42.8%). ICIs were discontinued in the majority of cases and then restarted in 7 patients with no recurrence of pericardial disease. Based on these results, ICI-associated G3-G4 pericardial disease as well as G2 pericardial disease with moderate-severe effusion should be treated with ICIs discontinuation and high-dose steroids, also performing pericardiocentesis, pericardial drainage or pericardial window in case of cardiac tamponade. For G2 with small effusion or G1 pericardial disease, ICIs might be continued and colchicine or NSAIDs could be considered. For patients requiring ICIs discontinuation, a rechallenge with ICIs seems to be feasible after resolution or meaningful improvement of pericardial disease.
Identifiants
pubmed: 33877385
doi: 10.1007/s00262-021-02938-z
pii: 10.1007/s00262-021-02938-z
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Types de publication
Case Reports
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
3041-3053Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Ribas A, Wolchok JD (2018) Cancer immunotherapy using checkpoint blockade. Science 359(6382):1350–1355. https://doi.org/10.1126/science.aar4060
doi: 10.1126/science.aar4060
pubmed: 29567705
pmcid: 7391259
Ribas A (2012) Tumor immunotherapy directed at PD-1. N Engl J Med 366(26):2517–2519. https://doi.org/10.1056/NEJMe1205943
doi: 10.1056/NEJMe1205943
pubmed: 22658126
Inno A, Metro G, Bironzo P et al (2017) Pathogenesis, clinical manifestations and management of immune checkpoint inhibitors toxicity. Tumori 103(5):405–421. https://doi.org/10.5301/tj.5000625
doi: 10.5301/tj.5000625
pubmed: 28497847
Lyon AR, Yousaf N, Battisti NML, Moslehi J, Larkin J (2018) Immune checkpoint inhibitors and cardiovascular toxicity. Lancet Oncol 19(9):e447–e458. https://doi.org/10.1016/S1470-2045(18)30457-1
doi: 10.1016/S1470-2045(18)30457-1
pubmed: 30191849
Hu JR, Florido R, Lipson EJ, et al. Cardiovascular toxicities associated with immune checkpoint inhibitors [published correction appears in Cardiovasc Res. 2019 Apr 15;115(5):868]. Cardiovasc Res 2019;115(5):854–868. https://doi.org/10.1093/cvr/cvz026
Salem JE, Manouchehri A, Moey M et al (2018) Cardiovascular toxicities associated with immune checkpoint inhibitors: an observational, retrospective, pharmacovigilance study. Lancet Oncol 19(12):1579–1589. https://doi.org/10.1016/S1470-2045(18)30608-9
doi: 10.1016/S1470-2045(18)30608-9
pubmed: 30442497
pmcid: 6287923
Chahine J, Collier P, Maroo A, Tang WW, Klein AL (2020) Myocardial and pericardial toxicity associated with immune checkpoint inhibitors in cancer patients. J Am Coll Cardiol Case Rep 2(2):191–199. https://doi.org/10.1016/j.jaccas.2019.11.080
doi: 10.1016/j.jaccas.2019.11.080
Canale ML, Camerini A, Casolo G et al (2020) Incidence of pericardial effusion in patients with advanced non-small cell lung cancer receiving immunotherapy. Adv Ther 37(7):3178–3184. https://doi.org/10.1007/s12325-020-01386-y
doi: 10.1007/s12325-020-01386-y
pubmed: 32436027
pmcid: 7467401
Brahmer JR, Lacchetti C, Schneider BJ et al (2018) Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 36(17):1714–1768. https://doi.org/10.1200/JCO.2017.77.6385
doi: 10.1200/JCO.2017.77.6385
pubmed: 29442540
Haanen JBAG, Carbonnel F, Robert C et al (2017) Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 28(suppl_4):iv119–iv142. https://doi.org/10.1093/annonc/mdx225 . Erratum in: Ann Oncol 2018; 29(Suppl 4):iv264–iv266. Erratum in: Ann Oncol 2018;29 Suppl 4:iv264–iv266
National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0. https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf
Altan M, Toki MI, Gettinger SN et al (2019) Immune checkpoint inhibitor-associated pericarditis. J Thorac Oncol 14(6):1102–1108. https://doi.org/10.1016/j.jtho.2019.02.026
doi: 10.1016/j.jtho.2019.02.026
pubmed: 30851443
pmcid: 6617516
Asai M, Kato Y, Kawai S et al (2019) Management of cardiac tamponade during nivolumab of lung cancer with intrapericardial bleomycin: case report. Immunotherapy 11(6):467–472. https://doi.org/10.2217/imt-2019-0003
doi: 10.2217/imt-2019-0003
pubmed: 30727791
Atallah-Yunes SA, Kadado AJ, Soe MH (2019) Pericardial effusion due to pembrolizumab-induced immunotoxicity: a case report and literature review. Curr Probl Cancer 43(5):504–510. https://doi.org/10.1016/j.currproblcancer.2019.01.001
doi: 10.1016/j.currproblcancer.2019.01.001
pubmed: 30685067
Chu YC, Fang KC, Chen HC et al (2017) Pericardial tamponade caused by a hypersensitivity response to tuberculosis reactivation after anti-PD-1 treatment in a patient with advanced pulmonary adenocarcinoma. J Thorac Oncol 12(8):e111–e114. https://doi.org/10.1016/j.jtho.2017.03.012
doi: 10.1016/j.jtho.2017.03.012
pubmed: 28748816
Dasanu CA, Jen T, Skulski R (2017) Late-onset pericardial tamponade, bilateral pleural effusions and recurrent immune monoarthritis induced by ipilimumab use for metastatic melanoma. J Oncol Pharm Pract 23(3):231–234. https://doi.org/10.1177/1078155216635853
doi: 10.1177/1078155216635853
pubmed: 26946531
de Almeida DVP, Gomes JR, Haddad FJ, Buzaid AC (2018) Immune-mediated pericarditis with pericardial tamponade during nivolumab therapy. J Immunother 41(7):329–331. https://doi.org/10.1097/CJI.0000000000000217
doi: 10.1097/CJI.0000000000000217
pubmed: 29461982
Dhenin A, Samartzi V, Lejeune S, Seront E (2019) Cascade of immunologic adverse events related to pembrolizumab treatment. BMJ Case Rep. 12(6):e229149. https://doi.org/10.1136/bcr-2018-229149
doi: 10.1136/bcr-2018-229149
pubmed: 31167767
pmcid: 6557364
Khan AM, Munir A, Thalody V, Munshi MK, Mehdi S (2019) Cardiac tamponade in a patient with stage IV lung adenocarcinoma treated with pembrolizumab. Immunotherapy 11(18):1533–1540. https://doi.org/10.2217/imt-2019-0067
doi: 10.2217/imt-2019-0067
pubmed: 31815569
Kolla BC, Patel MR (2016) Recurrent pleural effusions and cardiac tamponade as possible manifestations of pseudoprogression associated with nivolumab therapy—a report of two cases. J Immunother Cancer 4:80. https://doi.org/10.1186/s40425-016-0185-2
doi: 10.1186/s40425-016-0185-2
pubmed: 27895919
pmcid: 5109681
Kushnir I, Wolf I (2017) Nivolumab-induced pericardial tamponade: a case report and discussion. Cardiology 136(1):49–51. https://doi.org/10.1159/000447053
doi: 10.1159/000447053
pubmed: 27554835
Nesfeder J, Elsensohn AN, Thind M, Lennon J, Domsky S (2016) Pericardial effusion with tamponade physiology induced by nivolumab. Int J Cardiol 222:613–614. https://doi.org/10.1016/j.ijcard.2016.08.023
doi: 10.1016/j.ijcard.2016.08.023
pubmed: 27517649
Oristrell G, Bañeras J, Ros J, Muñoz E (2018) Cardiac tamponade and adrenal insufficiency due to pembrolizumab: a case report. Eur Heart J Case Rep. 2(2):tyt038. https://doi.org/10.1093/ehjcr/yty038
doi: 10.1093/ehjcr/yty038
Saade A, Mansuet-Lupo A, Arrondeau J et al (2019) Pericardial effusion under nivolumab: case-reports and review of the literature [published correction appears in J Immunother Cancer 7(1):335 (2019)]. J Immunother Cancer 7(1):266. https://doi.org/10.1186/s40425-019-0760-4
Shaheen S, Mirshahidi H, Nagaraj G, Hsueh CT (2018) Conservative management of nivolumab-induced pericardial effusion: a case report and review of literature. Exp Hematol Oncol 7:11. https://doi.org/10.1186/s40164-018-0104-y
doi: 10.1186/s40164-018-0104-y
pubmed: 29761026
pmcid: 5941729
Tachihara M, Yamamoto M, Yumura M, Yoshizaki A, Kobayashi K, Nishimura Y (2019) Non-parallel anti-tumour effects of pembrolizumab: a case of cardial tamponade. Respirol Case Rep. 7(3):e00404. https://doi.org/10.1002/rcr2.404
doi: 10.1002/rcr2.404
pubmed: 30733865
pmcid: 6354230
Vittorio A, Sharma R, Siejka D, Bhattarai K, Hardikar A (2018) Recurrent pericardial effusion while receiving nivolumab for metastatic lung adenocarcinoma: case report and review of the literature. Clin Lung Cancer 19(5):e717–e720. https://doi.org/10.1016/j.cllc.2018.05.010
doi: 10.1016/j.cllc.2018.05.010
pubmed: 29937384
Yamasaki M, Daido W, Saito N et al (2019) Pericardial effusion with tamponade in lung cancer patients during treatment with nivolumab: a report of two cases. Front Oncol 9:4. https://doi.org/10.3389/fonc.2019.00004
doi: 10.3389/fonc.2019.00004
pubmed: 30723699
pmcid: 6349695
Yun S, Vincelette ND, Mansour I, Hariri D, Motamed S (2015) Late onset ipilimumab-induced pericarditis and pericardial effusion: a rare but life threatening complication. Case Rep Oncol Med 2015:794842. https://doi.org/10.1155/2015/794842
doi: 10.1155/2015/794842
pubmed: 25918658
pmcid: 4396732
Zarogoulidis P, Chinelis P, Athanasiadou A et al (2017) Possible adverse effects of immunotherapy in non-small cell lung cancer; treatment and follow-up of three cases. Respir Med Case Rep 22:101–105. https://doi.org/10.1016/j.rmcr.2017.07.004
doi: 10.1016/j.rmcr.2017.07.004
pubmed: 28752057
pmcid: 5519224
Palaskas N, Morgan J, Daigle T et al (2019) Targeted cancer therapies with pericardial effusions requiring pericardiocentesis focusing on immune checkpoint inhibitors. Am J Cardiol 123(8):1351–1357. https://doi.org/10.1016/j.amjcard.2019.01.013
doi: 10.1016/j.amjcard.2019.01.013
pubmed: 30765065
Ala CK, Klein AL, Moslehi JJ (2019) Cancer treatment-associated pericardial disease: epidemiology, clinical presentation, diagnosis, and management. Curr Cardiol Rep 21(12):156. https://doi.org/10.1007/s11886-019-1225-6
doi: 10.1007/s11886-019-1225-6
pubmed: 31768769
Adler Y, Charron P (2015) The 2015 ESC Guidelines on the diagnosis and management of pericardial diseases. Eur Heart J 36(42):2873–2874. https://doi.org/10.1093/eurheartj/ehv479
doi: 10.1093/eurheartj/ehv479
pubmed: 26547486