ArticleFrontiers in cardiovascular medicine2025
A case series and literature review of immune checkpoint inhibitors-associated myocarditis (ICIM) in non-small cell lung cancer.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Immune Checkpoint Inhibitors-associated Myocarditis (ICIM) is a rare but life-threatening complication when treating Non-Small Cell Lung Cancer (NSCLC) with Immune Checkpoint Inhibitors (ICIs). This study aims to provide a foundation for optimizing the early identification, accurate stratification, and individualized treatment of ICIM. Methods: A retrospective analysis was performed on medical records of 5 NSCLC patients who developed myocarditis during ICI treatment. Data including demographics, medication history, clinical manifestations, lab tests, and imaging exams were collected, with analysis combined with a literature review. Results: The 5 patients (4 males and 1 female; aged 62-72 years, with varying NSCLC stages) developed myocardial injury within 1-3 cycles of ICI treatment. All had elevated myocardial markers and non-specific symptoms (palpitations, chest tightness, muscle weakness); 3 had abnormal electrocardiograms (ECGs). Diagnoses included 1 definite, 2 probable, and 2 possible ICIM cases. The glucocorticoid resistance rate was 80% (4/5), with only 1 patient responding effectively; mortality was 20% (1/5). No tumor progression was observed after ICI discontinuation [2 Partial Response [PR], 1 Stable Disease [SD], 1 pathological Complete Response [pCR]]. Conclusion: Early identification and intervention are critical for ICIM. The core treatment is ICI discontinuation plus glucocorticoid administration, but the optimal second-line regimen for glucocorticoid-resistant patients requires further investigation.
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