Sintilimab-induced myocarditis suspected in a patient with esophageal cancer and followed septic shock: case report and literature review

Frontiers in Oncology, Год журнала: 2024, Номер 14

Опубликована: Сен. 16, 2024

Background Immune checkpoint inhibitors (ICIs) have become a prevalent tool in anti-tumor therapy recent years. They may cause immune-related adverse events (irAEs) including potentially life-threatening cardiovascular toxicities such as myocarditis. Case presentation In this report, we describe 69-year-old man with recurrent esophageal cancer who developed myocarditis after receiving three cycles of sintilimab combined nab-paclitaxel. Despite rising cardiac troponin I (cTnI), he initially reported no discomfort. He was later suspected having sintilimab-induced Although treatment methylprednisolone reduced his cTnI levels, still experienced significant Moreover, pneumonia and septic shock. Conclusion our literature search to identify all cases sintilimab-associated involving myocarditis, found 14 patients, those cancer, thymoma, lung gastric hepatobiliary carcinoma, chordoma. The primary for ICI-induced cardiotoxicity is methylprednisolone. However, the long-term or high-dose use steroids can also induce side effects, which not been focus these case reports. This first asymptomatic immune-mediated occurring during sintilimab. It address effects used sintilimab-related To facilitate an early diagnosis, regular monitoring required treatment. We should on prevention management related steroid use.

Язык: Английский

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Plasma exchange plus glucocorticoids in the treatment of immune checkpoint inhibitor‐induced myocarditis: A case series and review

Clinical Cardiology, Год журнала: 2023, Номер 46(12), С. 1481 - 1487

Опубликована: Сен. 12, 2023

Abstract Immune checkpoint inhibitors (ICIs), including antiprogrammed cell‐death (PD)‐1/anti‐PD‐ligand (PDL‐1) monoclonal antibodies, are effective at improving the prognosis of patients with cancer. Among immune‐related adverse events, myocarditis associated anti‐PD‐1/anti‐PD‐L1 antibodies is rare but lacks treatment and mortality very high. In this study, authors extracted data from previous 8 years electronic medical records housed in hospital information system to identify hospitalized putatively caused by tumor therapy. Clinical these reported. Four who developed after undergoing for malignant tumors, all whom responded favorably therapy consisting plasma exchange glucocorticoids myocarditis, improved were discharged hospital. Plasma plus systemic may be treating antibody‐induced

Язык: Английский

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Fluorinated Chitosan‐Mediated Transepithelial Delivery of Intravesical Dual‐Drug Immunotherapeutic for Bladder Cancer Therapy

Advanced Therapeutics, Год журнала: 2024, Номер 7(7)

Опубликована: Июнь 7, 2024

Abstract Intravesical instillation‐based immunotherapy for bladder‐preservation of bladder cancer (BCa) treatment has not been explored. In the current study, two irrigated nano‐formulations immunological adjuvant‐fluorinated chitosan (FCS) and therapeutic antibody‐FCS are developed synergistic against BCa. this system, FCS is employed as a transepithelial carrier to assemble with bovine serum albumin (BSA)‐flubendazole (FBZ) complex anti‐PD‐1 (αPD‐1) respectively, facilitate efficient delivery intravesical FBZ‐BSA αPD‐1 though transiently regulating distribution tight junction proteins on epithelium. addition, FBZ–BSA exhibits tumor microenvironment‐responsive charge reversal BSA carrier‐broken effects drive tumor‐targeted dissociation drug release FBZ–BSA/FCS. Moreover, FBZ only promotes apoptosis inhibits glycolysis in cells but also displays adjuvant properties activate potent immune responses through IL‐12/IFN‐γ pathway. Interestingly, combined perfusion FBZ–BSA/FCS αPD‐1/FCS can significantly microenvironment, especially CD8 + T cell infiltration sensitivity, finally remarkably inhibit growth mouse orthotopic BCa model. Thus, study presents novel platform ICB antibodies smart system achieve synergy immunotherapy, which promising bladder‐preserving

Язык: Английский

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Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A Systematic Review

Diagnostics, Год журнала: 2024, Номер 14(16), С. 1794 - 1794

Опубликована: Авг. 16, 2024

Immune checkpoint inhibitors (ICIs) have significantly transformed cancer treatment, but their use is linked to immune-related adverse events (irAEs), including the rare ICI-associated myocarditis, myositis, and myasthenia gravis (MMM) overlap syndrome. This systematic review aims highlight MMM's clinical implications in emergency departments. PubMed Embase were searched using a specific search strategy. Reports eligible for inclusion if all three conditions present associated with of an ICI. Data extracted by independent reviewers Rayyan web application reviews. Descriptive statistics qualitative synthesis used summarize demographic, clinical, treatment data reported cases. Among 50 cases, predominantly melanoma, lung cancer, renal in-hospital mortality rate was 38.0%. The most commonly presenting symptoms ptosis (58%), dyspnea (48%), diplopia (42%), or myalgia (36%). median time from ICI initiation MMM presentation 21 days (interquartile range: 15-28 days). Corticosteroids primary irAEs. MMM, potentially fatal complication therapy, requires prompt recognition settings. should be initiated suspected, without waiting confirmation. Multidisciplinary collaboration vital diagnosis planning. Research on link cancers ICIs imperative better risk assessment interventions.

Язык: Английский

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Cardiac Complications of Immune Checkpoint Inhibitors and Chimeric Antigen Receptor T Cell Therapy

Cardiology Clinics, Год журнала: 2024, Номер 43(1), С. 151 - 167

Опубликована: Авг. 30, 2024

Язык: Английский

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Glucagon-like Peptide 1 Receptor Agonists in Cardio-Oncology: Pathophysiology of Cardiometabolic Outcomes in Cancer Patients

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(20), С. 11299 - 11299

Опубликована: Окт. 21, 2024

Cancer patients, especially long cancer survivors, are exposed to several cardio-metabolic diseases, including diabetes, heart failure, and atherosclerosis, which increase their risk of cardiovascular mortality. Therapy with glucagon-like peptide 1 (GLP1) receptor agonists demonstrated beneficial effects, atherosclerosis failure prevention. Cardiovascular outcome trials (CVOTs) suggest that GLP-1 RA could exert cardiorenal benefits systemic anti-inflammatory effects in patients type-2 diabetes through the activation cAMP PI3K/AkT pathways inhibition NLRP-3 MyD88. In this narrative review, we highlight biochemical properties a deep analysis clinical preclinical evidence primary prevention cardiomyopathies. The overall picture review encourages study as potential strategy against atherosclerosis.

Язык: Английский

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Reporting of late-onset immune-related adverse events with immune checkpoint inhibitors in VigiBase

Journal for ImmunoTherapy of Cancer, Год журнала: 2024, Номер 12(11), С. e009902 - e009902

Опубликована: Ноя. 1, 2024

Background To date, evidence on late-onset immune-related adverse events (irAEs) with immune checkpoint inhibitors (ICIs) is limited to a small number of clinical cases. This study aimed identify drug- and patient-related characteristics potentially associated the reporting irAEs ICIs in VigiBase, WHO global database individual case safety reports (ICSRs). Methods Observational comparing deduplicated ICSRs (occurred >90 days after ICI discontinuation) versus not irAEs, collected VigiBase from 2011 December 31, 2022. Logistic regression was used model relationship between drug-related irAEs. Significance determined for variables lower bound 95% CI OR (ROR) higher than 1 p value <0.05. Results The population consisted 6006 ICI-related (4574, 76.2%, originated Europe; 3900, 64.9%, involved males; median patient age 67 years, IQR 59–74 years). Of these, 344 (5.7%) reported total 388 among which most frequent were thyroiditis (n=45), pneumonitis (n=37), interstitial lung disease (n=25), hepatitis (n=23) vitiligo (n=19). Median time onset since discontinuation 167 (IQR 115–294 days), negligible proportion (3.2%) co-reported antineoplastic agents during period. models showed disproportionate combination therapy (ROR 2.33, 1.19 4.57), multiple 3.96, 2.85 5.52), cutaneous 1.83, 1.24 2.71), melanoma 1.47, 1.04 2.06). Conclusions pharmacovigilance provides largest series date identifies reporting. Dedicated prospective observational studies focused long-term sequelae, quality life survival patients developing should be planned confirm whether these are predictors actual occurrence. Furthermore, translational research encouraged clarify molecular mechanisms underlying irAE development.

Язык: Английский

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Exploring Pembrolizumab-Induced Myocarditis, Myositis, and Myasthenia Gravis: A Comprehensive Literature Review and Case Presentation on Bladder Cancer

Cureus, Год журнала: 2023, Номер unknown

Опубликована: Дек. 3, 2023

Pembrolizumab, a humanized monoclonal anti-programmed cell death protein 1 (PD1) antibody, has shown efficacy in various malignancies. This article presents case of stage III squamous carcinoma the bladder treated with pembrolizumab, resulting development rare overlap syndrome known as myocarditis, myositis, and myasthenia gravis (IM3OS). While immune checkpoint inhibitors like pembrolizumab demonstrate notable antitumor activity, they also pose risk severe immune-related adverse events. The underscores importance early detection IM3OS potential dangers associated delayed diagnosis, offering valuable insights for healthcare providers managing patients on therapy.

Язык: Английский

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