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Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies
Since the approval of the first immune checkpoint inhibitor (ICI) 9 years ago, ICI-therapy have revolutionized cancer treatment. Lately, antibodies blocking the interaction of programmed cell death protein (PD-1) and ligand (PD-L1) are gaining momentum as a cancer treatment, with multiple agents and...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887301/ https://www.ncbi.nlm.nih.gov/pubmed/33614750 http://dx.doi.org/10.3389/fcvm.2021.619650 |
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author | Xu, Shirley Sharma, Umesh C. Tuttle, Cheyanna Pokharel, Saraswati |
author_facet | Xu, Shirley Sharma, Umesh C. Tuttle, Cheyanna Pokharel, Saraswati |
author_sort | Xu, Shirley |
collection | PubMed |
description | Since the approval of the first immune checkpoint inhibitor (ICI) 9 years ago, ICI-therapy have revolutionized cancer treatment. Lately, antibodies blocking the interaction of programmed cell death protein (PD-1) and ligand (PD-L1) are gaining momentum as a cancer treatment, with multiple agents and cancer types being recently approved for treatment by the US Food and Drug Administration (FDA). Unfortunately, immunotherapy often leads to a wide range of immune related adverse events (IRAEs), including several severe cardiac effects and most notably myocarditis. While increased attention has been drawn to these side effects, including publication of multiple clinical observational data, the underlying mechanisms are unknown. In the event of IRAEs, the most widely utilized clinical solution is administration of high dose corticosteroids and in severe cases, discontinuation of these ICIs. This is detrimental as these therapies are often the last line of treatment options for many types of advanced cancer. In this review, we have systematically described the pathophysiology of the PD-1/PD-L1 axis (including a historical perspective) and cardiac effects in pre-clinical models, clinical trials, autoimmune mechanisms, and immunotherapy in combination with other cancer treatments. We have also reviewed the current challenges in the diagnosis of cardiac events and future directions in the field. In conclusion, this review will delve into this expanding field of cancer immunotherapy and the emerging adverse effects that should be quickly detected and prevented. |
format | Online Article Text |
id | pubmed-7887301 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78873012021-02-18 Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies Xu, Shirley Sharma, Umesh C. Tuttle, Cheyanna Pokharel, Saraswati Front Cardiovasc Med Cardiovascular Medicine Since the approval of the first immune checkpoint inhibitor (ICI) 9 years ago, ICI-therapy have revolutionized cancer treatment. Lately, antibodies blocking the interaction of programmed cell death protein (PD-1) and ligand (PD-L1) are gaining momentum as a cancer treatment, with multiple agents and cancer types being recently approved for treatment by the US Food and Drug Administration (FDA). Unfortunately, immunotherapy often leads to a wide range of immune related adverse events (IRAEs), including several severe cardiac effects and most notably myocarditis. While increased attention has been drawn to these side effects, including publication of multiple clinical observational data, the underlying mechanisms are unknown. In the event of IRAEs, the most widely utilized clinical solution is administration of high dose corticosteroids and in severe cases, discontinuation of these ICIs. This is detrimental as these therapies are often the last line of treatment options for many types of advanced cancer. In this review, we have systematically described the pathophysiology of the PD-1/PD-L1 axis (including a historical perspective) and cardiac effects in pre-clinical models, clinical trials, autoimmune mechanisms, and immunotherapy in combination with other cancer treatments. We have also reviewed the current challenges in the diagnosis of cardiac events and future directions in the field. In conclusion, this review will delve into this expanding field of cancer immunotherapy and the emerging adverse effects that should be quickly detected and prevented. Frontiers Media S.A. 2021-02-03 /pmc/articles/PMC7887301/ /pubmed/33614750 http://dx.doi.org/10.3389/fcvm.2021.619650 Text en Copyright © 2021 Xu, Sharma, Tuttle and Pokharel. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Xu, Shirley Sharma, Umesh C. Tuttle, Cheyanna Pokharel, Saraswati Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies |
title | Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies |
title_full | Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies |
title_fullStr | Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies |
title_full_unstemmed | Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies |
title_short | Immune Checkpoint Inhibitors: Cardiotoxicity in Pre-clinical Models and Clinical Studies |
title_sort | immune checkpoint inhibitors: cardiotoxicity in pre-clinical models and clinical studies |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887301/ https://www.ncbi.nlm.nih.gov/pubmed/33614750 http://dx.doi.org/10.3389/fcvm.2021.619650 |
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