Cardiovascular toxicity of immune therapies for cancer.

In addition to conventional chemoradiation and targeted cancer therapy, the use of immune based therapies, specifically immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T cell therapy (CAR-T), has increased exponentially across a wide spectrum of cancers. This has been paralleled by recognition of off-target immune related adverse events that can affect almost any organ system including the cardiovascular system. The use of ICIs has been associated with myocarditis, a less common but highly fatal adverse effect, pericarditis and pericardial effusions, vasculitis, thromboembolism, and potentially accelerated atherosclerosis. CAR-T resulting in a systemic cytokine release syndrome has been associated with myriad cardiovascular consequences including arrhythmias, myocardial infarction, and heart failure. This review summarizes the current state of knowledge regarding adverse cardiovascular effects associated with ICIs and CAR-T.

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Déclaration de conflit d'intérêts

Competing interests: We have read and understood the BMJ policy on declaration of interests and declare the following interests: NLP is partly supported by the Cancer Prevention Research Institute of Texas (CPRIT) RP200670, NIH/NCI 1P01CA261669-01, and has served as a consultant for Kiniksa Pharmaceuticals and Replimmune; EK is supported in part by NIH/NCI 1RO1HL157273 and CPRIT RP200381; AD is supported in part by the Ting Tsung and Wei Fong Distinguished Chair, NIH/NCI 1RO1HL157273, and CPRIT RP200381 and has served as a consultant for Bayer.