PD-1/PDL-1 Inhibitors and Cardiotoxicity; Molecular, Etiological and Management Outlines

J Adv Res. 2020 Oct 3:29:45-54. doi: 10.1016/j.jare.2020.09.006. eCollection 2021 Mar.

Abstract

Background: The US Food and Drug Administration (FDA) has approved several immunotherapeutic drugs for cancer since 2010, and many more are still being evaluated in other clinical studies. These inhibitors significantly increase response rates and result in the treatment of patients with advanced cancer. However, cancer immunotherapy leads to essential cardiac toxicity properties that have become distinct from other cancer patients' care and are mostly related to their etiology.

Aim of review: As potential implications, the occurrence of cardiovascular adverse events is particularly challenging and needs a comprehensive understanding of overall cancer-related etiology, clinical outcomes with different variable severity, and management.

Key scientific concepts of review: In terms of improving the overall survival of patients with cancer, clinicians should be careful in selecting either programmed cell death-1 (PD-1) or its programmed cell death ligand (PDL-1) inhibitors by evaluating their risk and clinical benefit for early intervention and decrease the level of morbidity and mortality of their patients. This review focuses on the effectiveness of PD-1/PL-1 antibodies and associated cardiotoxicity adverse events, including etiological mechanisms, diagnosis, and treatment.

Keywords: Cardiotoxicity; Heart block; Myocarditis; PD-1; PDL-1.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antineoplastic Agents, Immunological / administration & dosage
  • Antineoplastic Agents, Immunological / adverse effects
  • B7-H1 Antigen / antagonists & inhibitors*
  • Cardiotoxicity / diagnosis
  • Cardiotoxicity / etiology
  • Cardiotoxicity / therapy
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Heart Block / chemically induced
  • Heart Diseases / chemically induced*
  • Heart Diseases / diagnosis
  • Heart Diseases / therapy
  • Humans
  • Immunotherapy / adverse effects*
  • Immunotherapy / methods
  • Myocarditis / chemically induced
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • United States

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • Programmed Cell Death 1 Receptor