Pathophysiology, diagnosis and management of cardiac toxicity induced by immune checkpoint inhibitors and BRAF and MEK inhibitors.

Details

Serval ID
serval:BIB_63661F460346
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Pathophysiology, diagnosis and management of cardiac toxicity induced by immune checkpoint inhibitors and BRAF and MEK inhibitors.
Journal
Cancer treatment reviews
Author(s)
Arangalage D., Degrauwe N., Michielin O., Monney P., Özdemir B.C.
ISSN
1532-1967 (Electronic)
ISSN-L
0305-7372
Publication state
Published
Issued date
11/2021
Peer-reviewed
Oui
Volume
100
Pages
102282
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Immune checkpoint inhibitors (ICIs) and BRAF and MEK inhibitors (BRAFi/MEKi) have drastically improved the outcome of melanoma patients. ICIs can induce myocarditis, a rare immune related adverse event (irAE) with an estimated lethality of 50%. BRAFi/MEKi may induce left ventricular ejection fraction decrease, hypertension or QT interval prolongation. While the BRAFi/MEKi induced cardiotoxicity is often reversible upon treatment discontinuation or dose adaptation and symptomatic therapy is often sufficient to restore cardiac function, the treatment of ICI-induced myocarditis mainly relies on high dose corticosteroids. There is no established therapy for steroid resistant myocarditis, yet various drugs have been reported to improve outcome. Shared epitopes between melanoma cells and cardiac tissue are thought to underlie the development of ICIs induced myocarditis. The mechanism of BRAFi/MEKi induced cardiotoxicity appears to be related to the Ras-Raf-MEK-ERK pathway in cardiomyocyte repair, survival and proliferation. With the emerging application of ICI-BRAFi/MEKi combinations, so called triplet therapies, differentiating between these two types of cardiotoxicity will become important for appropriate patient management. In this article we provide a summary of the existing literature on the pathophysiology, diagnosis and management of cardiotoxicity of melanoma therapies.
Keywords
BRAF inhibitor, Cardiotoxicity, Heart failure, Hypertension, Immune checkpoint inhibitors, Immune related adverse events, MEK inhibitor, Melanoma, Myocarditis, Pathophysiology
Pubmed
Web of science
Open Access
Yes
Create date
15/09/2021 9:58
Last modification date
23/10/2021 5:38
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