Balancing anticancer therapy efficacy and safety in advanced hepatocellular carcinoma: a case report DOI Open Access
Mohamed Mourad, Layal Al Mahmasani,

Noura Abbas

et al.

Journal of Gastrointestinal Oncology, Journal Year: 2024, Volume and Issue: 15(6), P. 2712 - 2720

Published: Dec. 1, 2024

Hepatocellular carcinoma (HCC) is a significant health problem associated with several risk factors, increasingly driven by non-alcoholic steatohepatitis and metabolic syndrome. This association poses challenge for the primary treatments of HCC, which may include immune checkpoint inhibitors vascular endothelial growth factor inhibitors, due to their potential cardiotoxic effect. Therefore, it imperative balance therapeutic effects these agents cardiovascular adverse events. We describe case man in his seventies advanced HCC comorbidities who was treated atezolizumab bevacizumab. Despite achieving clinical radiologic complete response, patient experienced deterioration cardiac function after 16 months, necessitating discontinuation The continued respond well atezolizumab, but unfortunately, he passed away event 4 years follow-up. Careful stratification optimization modifiable factors uttermost importance management HCC. Close monitoring, comprehensive cardio-oncology clinic also vital, particularly patients at high developing delicate between efficacy cancer cardiotoxicity one principal determinants outcomes diagnosed

Language: Английский

Autoimmune Myocarditis, Old Dogs and New Tricks DOI Open Access
Taejoon Won, E Song,

Hannah M. Kalinoski

et al.

Circulation Research, Journal Year: 2024, Volume and Issue: 134(12), P. 1767 - 1790

Published: June 6, 2024

Autoimmunity significantly contributes to the pathogenesis of myocarditis, underscored by its increased frequency in autoimmune diseases such as systemic lupus erythematosus and polymyositis. Even cases myocarditis caused viral infections, dysregulated immune responses contribute pathogenesis. However, whether triggered existing conditions or precise antigens immunologic pathways driving remain incompletely understood. The emergence associated with checkpoint inhibitor therapy, commonly used for treating cancer, has afforded an opportunity understand mechanisms autoreactive T cells specific cardiac myosin playing a pivotal role. Despite their self-antigen recognition, myosin-specific can be present healthy individuals due bypassing thymic selection stage. In recent studies, novel modalities suppressing activity pathogenic including have proven effective myocarditis. This review offers overview current understanding heart antigens, autoantibodies, underlying various forms along latest updates on clinical management prospects future research.

Language: Английский

Citations

11
Recent Developments in the Management of Renal Cell Cancer DOI
Yu‐Wei Chen, Justine Panian, Brent S. Rose

et al.

JCO Oncology Practice, Journal Year: 2025, Volume and Issue: unknown

Published: March 6, 2025

The management of renal cell carcinoma (RCC) has seen significant advancements in recent years with the introduction novel therapeutic agents and combination regimens. Immune checkpoint inhibitors (ICIs) have revolutionized treatment landscape, particularly for advanced metastatic RCC, where ICI-based combinations shown substantial improvements survival outcomes. Dual immunotherapy combinations, such as nivolumab plus ipilimumab, ICI-vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) including pembrolizumab axitinib, cabozantinib, lenvatinib, demonstrated overall (OS) benefits first-line treatment, redefining standard care RCC. Adjuvant is also approved resected high-risk RCC only adjuvant therapy that prolongs OS Additionally, development belzutifan, a hypoxia-inducible factor-2 alpha inhibitor, offers new option patients whose disease progresses after ICI VEGF TKI therapies. Recent results from CONTACT-3 TiNiVo-2 confirm rechallenge should be generally discouraged. This review provides detailed overview current evidence supporting immune-based well insights into sequencing strategies

Language: Английский

Citations

1
Soluble Immune Checkpoint Protein and Lipid Network Associations with All-Cause Mortality Risk: Trans-Omics for Precision Medicine (TOPMed) Program DOI
Annabelle Rodríguez, Chaojie Yang, Weiniu Gan

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 9, 2025

Adverse cardiovascular events are emerging with the use of immune checkpoint therapies in oncology. Using datasets Trans-Omics for Precision Medicine program (Multi-Ethnic Study Atherosclerosis, Jackson Heart [JHS], and Framingham Study), we examined association plasma proteins each other, their associated protein network high-density lipoprotein cholesterol (HDL-C) low-density (LDL-C), HDL-C- LDL-C-associated networks all-cause mortality risk. Plasma levels LAG3 HAVCR2 showed statistically significant associations Colocalization analysis using genome wide-association studies HDL-C or LDL-C quantitative trait loci from JHS Atherosclerosis Risk Communities identified TFF3 rs60467699 CD36 rs3211938 variants as significantly colocalized HDL-C; contrast, none LDL-C. The measurement LAG3, HAVCR2, plus targeted genotyping may identify patients at increased

Language: Английский

Citations

0
The role of immune checkpoints PD-1 and CTLA-4 in cardiovascular complications leading to heart failure DOI Creative Commons
Song Huang, Yu Kang, Ting Liu

et al.

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: April 4, 2025

Immune checkpoints, such as PD-1 and CTLA-4, are crucial regulators of immune responses, acting gatekeepers to balance immunity against foreign antigens self-tolerance. These checkpoints play a key role in maintaining cardiac homeostasis by preventing immune-mediated damage critical organs like the heart. In this study, we explored involvement CTLA-4 cardiovascular complications, particularly atherosclerosis myocarditis, which can lead heart failure. We conducted comprehensive analysis using animal models clinical data assess effects checkpoint inhibition on function. Our findings indicate that disruption pathways exacerbates myocardial inflammation, accelerates atherosclerotic plaque formation, promotes development Additionally, observed these led increased infiltration T lymphocytes, higher levels pro-inflammatory cytokines, enhanced tissue damage. results suggest preserving health, their result severe toxicity. study emphasizes need for careful monitoring health patients undergoing inhibitor therapies.

Language: Английский

Citations

0
Advancing Precision Medicine: Uncovering Biomarkers and Strategies to Mitigate Immune-Related Adverse Events in Immune Checkpoint Inhibitors Therapy DOI Creative Commons

K L Nityashree,

P. Rachitha,

Shilpa Hanchinmane

et al.

Toxicology Reports, Journal Year: 2025, Volume and Issue: unknown, P. 102035 - 102035

Published: April 1, 2025

Language: Английский

Citations

0
Anticancer Chemotherapy-Induced Atherosclerotic Cardiovascular Disease: A Comprehensive Review DOI Creative Commons
Juan S. Izquierdo‐Condoy, Marlon Arias-Intriago, Daniel Cardona

et al.

Life, Journal Year: 2025, Volume and Issue: 15(2), P. 245 - 245

Published: Feb. 6, 2025

The introduction of anticancer agents has transformed oncology, significantly improving survival rates. However, these therapies have introduced unintended cardiovascular risks, with atherosclerovascular disease (ASCVD) emerging as a leading cause morbidity and mortality among cancer survivors. development ASCVD in this population involves multifactorial mechanisms, including endothelial dysfunction, oxidative stress, systemic inflammation, disrupted lipid metabolism. This review examines the various mechanisms through which chemotherapy contributes to highlights strategies for risk assessment management. Each class presents distinct challenges: anthracyclines induce stress damage, promoting foam cell formation plaque progression; taxanes vascular growth factor (VEGF) inhibitors impair metabolism stability; anti-metabolites exacerbate injury reactive oxygen species; mTOR inhibitors, hormonal therapies, tyrosine kinase immune checkpoint disrupt profiles inflammatory pathways, increasing rupture thrombosis. Mitigating chemotherapy-induced necessitates comprehensive, multidisciplinary approach. Detailed pre-treatment assessments must address traditional cancer-specific factors, demographics, pre-existing conditions, modifiable behaviors such smoking inactivity. Pharmacological interventions like statins angiotensin-converting enzyme (ACE) paired lifestyle modifications, are essential reducing risk. In resource-limited settings, cost-effective should be prioritized enhance accessibility. Establishing cardio-oncology units facilitates care coordination, while long-term surveillance enables timely detection intervention. These collectively improve outcomes survivorship diverse patient populations.

Language: Английский

Citations

0
Efficacy of high-dose steroids versus low-dose steroids in the treatment of immune checkpoint inhibitor-associated myocarditis: a case series and systematic review DOI Creative Commons

Xiuyue Man,

Hong Wang, Chen Chen

et al.

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 12, 2025

Immune checkpoint inhibitor-associated myocarditis (ICI-M) is a rare yet potentially fatal complication of immunotherapy, with no standardized treatment protocol due to limited data. The use varying steroid doses has resulted in inconsistent outcomes. We retrospectively identified patients diagnosed ICI-M at our institution between January 2020 and February 2024. Additionally, we conducted comprehensive literature review using PubMed, Embase, the Cochrane Library facilitate comparative analysis clinical responses. primary aim was compare outcomes therapeutic responses treated high-dose versus low-dose methylprednisolone. Patients receiving an initial intravenous methylprednisolone (1 g/day) exhibited more rapid reduction myocardial injury markers, including troponin I/T (cTnI/T), creatine kinase (CK), N-terminal pro b-type natriuretic peptide (NT-proBNP), compared those lower doses. This group also demonstrated incidences biomarker rebound maintained levels over time. process straightforward group, efficacy surpassing that observed who received (mPSL) dose less than 1 g/day. Regarding prognosis, incidence major adverse cardiovascular events (MACE) mortality significantly group. In immune myocarditis, prompt administration corticosteroid pulse therapy strongly associated improved intervention rapidly lowers biomarkers (cTnI/T, CK, NT-proBNP) while minimizing risk rebound, thus optimizing management. Notably, it reduces (MACE), thereby enhancing patient prognosis. duration should be tailored based on response. cases resistance, combination therapies may provide additional benefit.

Language: Английский

Citations

0
The inflammation burden index can predict the cardiac injury following antitumour therapy in lung cancer patients with diabetes DOI Creative Commons
Yumin Wang, Chunyan Huan, Guodong Wang

et al.

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: April 2, 2025

Language: Английский

Citations

0
Novel Cancer Therapeutics: Perioperative Implications and Challenges DOI
Cristina Gutiérrez, Prabalini Rajendram, Olakunle Idowu

et al.

Anesthesia & Analgesia, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 25, 2024

Since the introduction of immunotherapy and targeted therapies, patients not only have adequate tumoral response to these treatments, but their quality life has improved due milder toxicities. However, wide mechanisms action, toxicity profile for therapies is broad, can an insidious onset, recognition be challenging. Rarely, some toxicities cause significant morbidity if diagnosed early lead intensive care unit (ICU) admission death. Anesthesiologists are likely encounter a spectrum also range severity. In cases, they could first make diagnosis therefore need prepared rapidly assess, establish differentials, perform diagnostic workup, evaluate impact on patients' during perioperative period. this article, we set review novel cancer such as checkpoint inhibitors that present in setting. This article will help guide anesthesiologists recognize clinical presentation, approach diagnosis, patient care.

Language: Английский

Citations

2
Respiratory pathology and cardiovascular diseases: A Scoping Review DOI Creative Commons
Francisco Campos‐Rodríguez, Eusebi Chiner, David de la Rosa

et al.

Open Respiratory Archives, Journal Year: 2024, Volume and Issue: 7(1), P. 100392 - 100392

Published: Nov. 23, 2024

Language: Английский

Citations

2