Monoclonal Antibody-Based Immunotherapy and Its Role in the Development of Cardiac Toxicity

Kumar, Mohit; Thangavel, Chellappagounder; Becker, Richard C.; Sadayappan, Sakthivel

doi:10.3390/cancers13010086

Cited by 24 publications

(17 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hypertension is common cardiovascular toxicity ( 9 ). We reviewed the relevant literature and found that no study reported the effect of ICIs therapy on the risk of hypertension, so we counted the incidence of hypertension in the included study.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular toxicity of PD-1/PD-L1 inhibitors includes hypertension, myocarditis, arrhythmia, heart failure, myocardial infarction, pericardial effusion and cardiac arrest (8)(9)(10). We performed statistics on several cardiovascular toxicities included in the study, and the results showed that the incidence of all-grade myocarditis in the patients undergoing PD-1/PD-L1 inhibitors monotherapy was 0.13%, myocardial infarction 0.11%, pericardial effusion 0.08%, arrhythmia 0.17%, heart failure 0.11%, cardiac arrest 0.06% and hypertension 0.21%.…”

Section: Discussionmentioning

confidence: 99%

“…PD-1/PD-L1 inhibitors-related cardiovascular toxicity includes myocarditis, hypertension, heart failure, pericardial disease, prolonged QT interval, heart block, left ventricular insufficiency, decreased ejection fraction, ventricular arrhythmia, cardiogenic shock and cardiac arrest (8)(9)(10). Once myocarditis occurs, its fatality rate is about 39.7%-50% (11,12).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiovascular Toxicity With PD-1/PD-L1 Inhibitors in Cancer Patients: A Systematic Review and Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

BackgroundPD-1/PD-L1 inhibitors have significantly improved the outcomes of those patients with various malignancies. However, the incidence of adverse events also increased. This meta-analysis aims to systematically evaluate the risk of cardiovascular toxicity in patients treated with PD-1/PD-L1 inhibitors.Materials and methodsWe searched PubMed, Embase, the Cochrane Library databases for all randomized controlled trials (RCTs) comparing all-grade and grade 3-5 cardiovascular toxicity of single-agent PD-1/PD-L1 inhibitors to placebo/chemotherapy, PD-1/PD-L1 inhibitors combined with chemotherapy to chemotherapy, or PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors to single-agent immune checkpoint inhibitors (ICIs) and pooled our data in a meta-analysis stratified by tumor types and PD-1 or PD-L1 inhibitors. The Mantel-Haenszel method calculated the odds ratio (OR) and its corresponding 95% confidence intervals (CIs).ResultsA total of 50 trials were included in the analysis. Single-agent PD-1/PD-L1 inhibitors increased the risk of all-grade cardiotoxicity compared with placebo (OR=2.11, 95%CI 1.02-4.36, P=0.04). Compared with chemotherapy, patients receiving PD-1/PD-L1 inhibitors combined with chemotherapy had a significant higher risk of all-grade (OR=1.53, 95%CI 1.18-1.99, P=0.001) and grade 3-5 cardiotoxicity (OR=1.63, 95%CI 1.11-2.39, P=0.01) cardiotoxicity, especially patients with non-small cell lung cancer (NSCLC) [all-grade cardiotoxicity (OR=1.97, 95%CI 1.14-3.41, P=0.02) and grade 3-5 cardiotoxicity (OR=2.15, 95%CI 1.08-4.27, P=0.03)]. Subgroup analysis showed that PD-1 inhibitors combined with chemotherapy were associated with a higher risk of grade 3-5 cardiotoxicity (OR=2.08, 95%CI 1.18-3.66, P=0.01). Compared with placebo or chemotherapy, single-agent PD-1/PD-L1 inhibitors did not increase the risk of all-grade of myocarditis, arrhythmia and hypertension. However, PD-1/PD-L1 inhibitors combined with chemotherapy increased the risk of all-grade arrhythmia (OR=1.63, 95%CI 1.07-2.46, P=0.02) [PD-L1 inhibitor-containing treatment (OR=1.75, 95%CI 1.09-2.80, P=0.02)], and the risk of all-grade hypertension (OR=1.34, 95%CI 1.02-1.77, P=0.04) and grade 3-5 hypertension (OR=1.54, 95%CI 1.10-2.15, P=0.01).ConclusionsOur results suggest that single-agent PD-1/PD-L1 inhibitors increase the risk of all-grade cardiotoxicity, PD-1/PD-L1 inhibitors combined with chemotherapy increase the risk of all-grade and grade 3-5 cardiotoxicity, especially in those patients treated with PD-1 inhibitor-containing treatment and those with NSCLC. In addition, PD-1/PD-L1 inhibitors combined with chemotherapy increase the risk of arrhythmia and hypertension. Therefore, this evidence should be considered when assessing the benefits and risks of PD-1/PD-L1 inhibitors in treating malignancies.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022303115.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular Toxicity With PD-1/PD-L1 Inhibitors in Cancer Patients: A Systematic Review and Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Antibody-based immunotherapy has been a major and rational therapeutic strategy in the clinical management of oncology ( 209 , 210 ). In clinical practice, therapeutic mAbs have a limited effectiveness in the treatment of solid tumours due to their large molecular weight, but a high degree of targeting ( 198 ).…”

Section: Application Of Monoclonal Antibodies In Tumour Therapymentioning

confidence: 99%

Retrospective analysis of the preparation and application of immunotherapy in cancer treatment (Review)

Ding

et al. 2022

Int J Oncol

View full text Add to dashboard Cite

Monoclonal antibody technology plays a vital role in biomedical and immunotherapy, which greatly promotes the study of the structure and function of genes and proteins. To date, monoclonal antibodies have gone through four stages: murine monoclonal antibody, chimeric monoclonal antibody, humanised monoclonal antibody and fully human monoclonal antibody; thousands of monoclonal antibodies have been used in the fields of biology and medicine, playing a special role in the pathogenesis, diagnosis and treatment of disease. In this review, we compare the advantages and disadvantages of hybridoma technology, phage display technology, ribosome display technology, transgenic mouse technology, single B cell monoclonal antibody generation technologies, and forecast the promising applications of these technologies in clinical medicine, disease diagnosis and tumour treatment. Contents 1. Introduction 2. Immunotherapy and antibodies 3. Monoclonal antibody preparation techniques and their applications 4. Application of monoclonal antibodies in tumour therapy 5. Monoclonal antibody drugs and market value 6. Prospects

show abstract

“…The treatment of the cancer uses various methods such as surgery, radiotherapy [18], immunotherapy, or chemotherapy [19]. In the case of immuno-or chemotherapy it is crucial to develop a method of targeted delivery of specific antibodies, antisense nucleic acids, or chemotherapeutic drugs inside the affected tissues [20]. This approach can help in avoiding the undesirable toxic effect of drugs on normal, healthy cells.…”

Section: Introductionmentioning

confidence: 99%

Polymer Nanoparticles and Nanomotors Modified by DNA/RNA Aptamers and Antibodies in Targeted Therapy of Cancer

2021

View full text Add to dashboard Cite

Polymer nanoparticles and nano/micromotors are novel nanostructures that are of increased interest especially in the diagnosis and therapy of cancer. These structures are modified by antibodies or nucleic acid aptamers and can recognize the cancer markers at the membrane of the cancer cells or in the intracellular side. They can serve as a cargo for targeted transport of drugs or nucleic acids in chemo- immuno- or gene therapy. The various mechanisms, such as enzyme, ultrasound, magnetic, electrical, or light, served as a driving force for nano/micromotors, allowing their transport into the cells. This review is focused on the recent achievements in the development of polymer nanoparticles and nano/micromotors modified by antibodies and nucleic acid aptamers. The methods of preparation of polymer nanoparticles, their structure and properties are provided together with those for synthesis and the application of nano/micromotors. The various mechanisms of the driving of nano/micromotors such as chemical, light, ultrasound, electric and magnetic fields are explained. The targeting drug delivery is based on the modification of nanostructures by receptors such as nucleic acid aptamers and antibodies. Special focus is therefore on the method of selection aptamers for recognition cancer markers as well as on the comparison of the properties of nucleic acid aptamers and antibodies. The methods of immobilization of aptamers at the nanoparticles and nano/micromotors are provided. Examples of applications of polymer nanoparticles and nano/micromotors in targeted delivery and in controlled drug release are presented. The future perspectives of biomimetic nanostructures in personalized nanomedicine are also discussed.

show abstract

Monoclonal Antibody-Based Immunotherapy and Its Role in the Development of Cardiac Toxicity

Cited by 24 publications

References 58 publications

Cardiovascular Toxicity With PD-1/PD-L1 Inhibitors in Cancer Patients: A Systematic Review and Meta-Analysis

Cardiovascular Toxicity With PD-1/PD-L1 Inhibitors in Cancer Patients: A Systematic Review and Meta-Analysis

Retrospective analysis of the preparation and application of immunotherapy in cancer treatment (Review)

Polymer Nanoparticles and Nanomotors Modified by DNA/RNA Aptamers and Antibodies in Targeted Therapy of Cancer

Contact Info

Product

Resources

About