Myocarditis as an immune-related adverse event with ipilimumab/nivolumab combination therapy for metastatic melanoma

Myocarditis Associated with Immune Checkpoint Inhibitors: An Expert Consensus on Data Gaps and a Call to Action

“…The first specific report of myocarditis during treatment with a PD‐1/PD‐L1 inhibitor was published in 2014 [27], and a number of cases of ICI‐associated myocarditis have been described since . In an early analysis of more than 20,000 patients treated with ICIs, either alone or in combination, the incidence of myocarditis was 0.09%; the incidence of fatal myocarditis in this sample was 0.03% .…”

“…Like most irAEs, which typically emerge early in the course of treatment , preliminary observations suggest ICI‐associated myocarditis generally occurs within 3 months of treatment initiation . Management of ICI‐associated myocarditis varies in published reports but frequently includes administration of corticosteroids , with outcomes ranging from complete resolution to the occurrence of major adverse cardiac events and/or death.…”

Immune‐related fulminant myocarditis in a patient receiving ipilimumab therapy for relapsed chronic myelomonocytic leukaemia

“…Work‐up revealed a mildly elevated troponin‐T (peak 0.12 ng/mL), which was followed by an echocardiogram showing preserved left ventricular systolic function and a coronary angiogram demonstrating normal coronary arteries. The patient's symptoms resolved with high‐dose corticosteroids and discontinuation of combination immunotherapy . It is notable that our patient's clinical course was defined by rapidly progressive electrical instability, marked by atrioventricular conduction disease and bradyarrhythmias.…”

Ipilimumab-nivolumab therapy causing STEMI in a melanoma patient: A case report

“…[28] Myositis, cardiomyopathy, and conduction aberrances have all been connected to CTLA-4/PD-1 inhibitor therapy. [16][17][18][19][20] To our knowledge, this is the first suspected case of de novo intra-arterial thrombus formation leading to STEMI in CTLA-4/PD-1 inhibitor therapy. Given the concern for the cardiovascular effects of these agents and growing side effect profile, increased and more aggressive screening may be warranted in certain higher-risk individuals prior to initiation of therapy.…”

“…[15] Furthermore, cardiac conduction abnormalities and myocarditis (including fulminant myocarditis leading to death) have been reported. [16][17][18][19][20] We report a case of ST-elevation myocardial infarction (STEMI) in the setting of new intra-arterial thrombus formation, severe systolic heart failure, and left ventricular throm-bus in a middle-aged woman with metastatic melanoma on ipilimumab-nivolumab therapy.…”