ArticleClinical research in cardiology : official journal of the German Cardiac Society2021
Re-introducing immunotherapy in patients surviving immune checkpoint inhibitors-mediated myocarditis.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Safety and Efficacy of Rechallenge With Immune Checkpoint Inhibitors in Advanced Solid Tumor: A Systematic Review and Meta-Analysis.Cancer medicine · 2024Pooled it
- Cardiac Toxicity Associated with Immune Checkpoint Inhibitors: A Systematic Review.International journal of molecular sciences · 2022Pooled it
- A narrative review of immune checkpoint inhibitor-related cardiotoxicity in lung cancer: mechanisms, risk stratification, and clinical management.Journal of thoracic disease · 2026Review
- Endomyocardial Biopsies in the Diagnostic Workup of Immune Checkpoint Inhibitor Associated Myocarditis.Current heart failure reports · 2026Review
- Clonal reshaping and clinical outcomes after rechallenge in ICI-associated myocarditis: integrated single-cell and TCR repertoire analysis.Journal for immunotherapy of cancer · 2026Article
- Immune Checkpoint Inhibitor-Associated Myocarditis: Risk, Diagnosis, and Clinical Impact.Journal of clinical medicine · 2026Review
- Article
- Perimyocarditis Associated with Immune Checkpoint Inhibitors: A Case Report and Review of the Literature.Medicina (Kaunas, Lithuania) · 2024Review
- Immunotherapy-associated cardiovascular toxicities: insights from preclinical and clinical studies.Frontiers in oncology · 2024Review
- Immune Checkpoint Inhibitors-Associated Myocarditis: Diagnosis, Treatment and Current Status on Rechallenge.Journal of clinical medicine · 2023Review
- Review
- Cardiovascular Effects of Immune Checkpoint Inhibitors: More Than Just Myocarditis.Current oncology reports · 2023Review
- A case of subclinical immune checkpoint inhibitor-associated myocarditis in non-small cell lung cancer.BMC pulmonary medicine · 2023Article
- Immunotherapy Resumption/Rechallenge in Melanoma Patients after Toxicity: Do We Have Another Chance?Pharmaceutics · 2023Review
- Immune Checkpoint Inhibitors and Their Cardiovascular Adverse Effects.Oncology reviews · 2023Review
- Immune Checkpoint Inhibitors Related to Cardiotoxicity.Journal of cardiovascular development and disease · 2022Review
- Cardiac Magnetic Resonance Imaging in Immune Check-Point Inhibitor Myocarditis: A Systematic Review.Journal of imaging · 2022Review
- Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study.PloS one · 2022Observational
- Clinical characteristics, time course, treatment and outcomes of patients with immune checkpoint inhibitor-associated myocarditis.Journal for immunotherapy of cancer · 2021Article
- The Role of Speckle Strain Echocardiography in the Diagnosis of Early Subclinical Cardiac Injury in Cancer Patients-Is There More Than Just Left Ventricle Global Longitudinal Strain?Journal of clinical medicine · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmune checkpoint inhibitors (ICI) have transformed the standard care of cancer treatment. Recent case reports describe ICI-mediated myocarditis with an atypical presentation and fatal potential which lead to permanent interruption of immunotherapy.
objectivesTo characterize ICI-mediated myocarditis and re-introduction to immunotherapy.
methodsDuring 2019, 849 patients were treated with ICI at Tel Aviv Sourasky Medical Center for the diagnosis of lung adenocarcinoma, gastric adenocarcinoma, urothelial carcinoma, and hepatocellular carcinoma. Overall, seven (0.8%) patients were diagnosed with ICI-mediated myocarditis, according to the European Society of Cardiology guidelines of myocarditis 2013. We retrospectively evaluated their presentation, severity, and clinical outcomes.
resultsAmong the seven patients, only one had a history of cardiac disease. The majority were diagnosed with lung adenocarcinoma and treated with anti-programmed death-1 antibody. All patients were treated with single-agent ICI. Most patients presented with cardiac symptoms, elevated troponin and typical cardiac magnetic resonance; however, only three had reduced ejection fraction. Overall, three patients were chosen for re-introduction with concomitant low dose steroids and weekly troponin follow-up. Two patients diagnosed with grade I and II renewed therapy successfully with no recurrence of symptoms and improvement in disease burden. The one patient diagnosed with grade III developed worsening of cardiac symptoms after the 1st cycle and, therefore, therapy was interrupted permanently.
conclusionsICI-mediated myocarditis is potentially fatal and leads to permanent interruption of life-saving cancer therapy. The current data suggest that re-introduction may be considered in low-grade patients; however, a better definition of the diagnosis and grading is needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.