title: Cardiovascular Toxicities Associated with Cancer Immunotherapies.
abstract: We review the cardiovascular toxicities associated with cancer immune therapies and discuss the cardiac manifestations, potential mechanisms, and management strategies.
  
  
  
  The recent advances in cancer immune therapy with immune checkpoint inhibitors and adoptive cell transfer have improved clinical outcomes in numerous cancers. The rising use of cancer immune therapy will lead to a higher incidence in immune-related adverse events. Recent studies have highlighted several reports of severe cases of acute cardiotoxic events with immune therapy including fulminant myocarditis. We believe that immune-mediated myocarditis is a driving mechanism behind these cardiovascular toxicities and requires vigilant screening and prompt management with corticosteroids and immune-modulating drugs, especially with combination immune therapies. While the incidence of serious cardiovascular toxicities with immune therapy appears low, these can be life-threatening especially when manifesting as acute immune-mediated myocarditis. Further collaborative studies are needed to effectively identify, characterize, and manage these events.
authors.affiliation: Divisions of Oncology, Department of Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, 777 Preston Research Bldg., Nashville, TN, 37232, USA.
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Wang
authors.affiliation: Department of Medicine, Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Medicine, Cardio-Oncology Program, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Gosife Donald
authors.initials: GD
authors.lastname: Okoye
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.|Department of Medicine, Cardio-Oncology Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Neilan
authors.affiliation: Divisions of Oncology, Department of Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, 777 Preston Research Bldg., Nashville, TN, 37232, USA. douglas.b.johnson@vanderbilt.edu.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Johnson
authors.affiliation: Divisions of Oncology, Department of Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, 777 Preston Research Bldg., Nashville, TN, 37232, USA.|Department of Medicine, Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Medicine, Cardio-Oncology Program, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Javid J
authors.initials: JJ
authors.lastname: Moslehi
mesh_terms: D019264:Adoptive Transfer / Q000009:adverse effects; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D009205:Myocarditis / Q000209:etiology* / Q000276:immunology; D009369:Neoplasms / Q000628:therapy*
keywords: CTLA-4; Cardiovascular toxicities; Checkpoint inhibitors; Immune therapy; Myocarditis; PD-1