Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma
Abstract Combination therapy with nivolumab and ipilimumab for advanced renal cell carcinoma (RCC) may cause immune-related myocarditis; however, its incidence in this cancer type and regimen remains unknown. At our institution, we measure biomarkers, such as high-sensitivity Troponin (hsTn), and pe...
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| Format: | Article |
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Springer
2025-02-01
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| Series: | Cancer Immunology, Immunotherapy |
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| Online Access: | https://doi.org/10.1007/s00262-025-03945-0 |
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| author | Maki Todo Yodo Gatate Shintaro Nakano Go Kaneko Masayuki Hagiwara Takayuki Takahashi Yuta Umezawa Genji Ueda Shiho Ishikawa Yoshinori Makino Masafumi Oyama Suguru Shirotake |
| author_facet | Maki Todo Yodo Gatate Shintaro Nakano Go Kaneko Masayuki Hagiwara Takayuki Takahashi Yuta Umezawa Genji Ueda Shiho Ishikawa Yoshinori Makino Masafumi Oyama Suguru Shirotake |
| author_sort | Maki Todo |
| collection | DOAJ |
| description | Abstract Combination therapy with nivolumab and ipilimumab for advanced renal cell carcinoma (RCC) may cause immune-related myocarditis; however, its incidence in this cancer type and regimen remains unknown. At our institution, we measure biomarkers, such as high-sensitivity Troponin (hsTn), and perform electrocardiograms (ECGs) and echocardiography before and every month after the initiation of this therapy, and the findings obtained and patients’ symptoms are continuously monitored by physicians and pharmacists. A retrospective survey was conducted on physiological and biochemical test findings and immune-related adverse events in patients with advanced RCC who received combination therapy with nivolumab and ipilimumab between October 1, 2018 and December 31, 2023. Patients suspected of having myocarditis consulted with cardiologists. Myocarditis due to this therapy was detected in 5 of the 86 patients (5.8%) assessed using the European Society of Cardiology 2022 guidelines. There were no fatal symptoms or death due to myocarditis. The median time to the onset of myocarditis was 25 days (21–86 days). The early detection of myocarditis caused by this therapy requires the monitoring of changes by periodically measuring hsTn and other cardiac markers and performing ECGs and echocardiography from the early stages of administration through to the end of treatment. In addition to checking symptoms, if these abnormalities are detected and myocarditis is suspected, prompt collaboration with cardiologists is recommended. Our management strategy of care by a onco-cardiology team may contribute to the early diagnosis and treatment of myocarditis. |
| format | Article |
| id | doaj-art-14417af09ed644dd96a903de8ac85cc2 |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Springer |
| record_format | Article |
| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-14417af09ed644dd96a903de8ac85cc22025-02-09T12:39:10ZengSpringerCancer Immunology, Immunotherapy1432-08512025-02-0174311110.1007/s00262-025-03945-0Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinomaMaki Todo0Yodo Gatate1Shintaro Nakano2Go Kaneko3Masayuki Hagiwara4Takayuki Takahashi5Yuta Umezawa6Genji Ueda7Shiho Ishikawa8Yoshinori Makino9Masafumi Oyama10Suguru Shirotake11Department of Pharmacy, Saitama Medical University Saitama International Medical CenterDepartment of Cardiology, Saitama Medical University Saitama International Medical CenterDepartment of Cardiology, Saitama Medical University Saitama International Medical CenterDepartment of Uro-Oncology, Saitama Medical University Saitama International Medical CenterDepartment of Uro-Oncology, Saitama Medical University Saitama International Medical CenterDepartment of Uro-Oncology, Saitama Medical University Saitama International Medical CenterDepartment of Uro-Oncology, Saitama Medical University Saitama International Medical CenterDepartment of Pharmacy, Saitama Medical University Saitama International Medical CenterDepartment of Pharmacy, Saitama Medical University Saitama International Medical CenterDepartment of Pharmacy, Saitama Medical University Saitama International Medical CenterDepartment of Uro-Oncology, Saitama Medical University Saitama International Medical CenterDepartment of Uro-Oncology, Saitama Medical University Saitama International Medical CenterAbstract Combination therapy with nivolumab and ipilimumab for advanced renal cell carcinoma (RCC) may cause immune-related myocarditis; however, its incidence in this cancer type and regimen remains unknown. At our institution, we measure biomarkers, such as high-sensitivity Troponin (hsTn), and perform electrocardiograms (ECGs) and echocardiography before and every month after the initiation of this therapy, and the findings obtained and patients’ symptoms are continuously monitored by physicians and pharmacists. A retrospective survey was conducted on physiological and biochemical test findings and immune-related adverse events in patients with advanced RCC who received combination therapy with nivolumab and ipilimumab between October 1, 2018 and December 31, 2023. Patients suspected of having myocarditis consulted with cardiologists. Myocarditis due to this therapy was detected in 5 of the 86 patients (5.8%) assessed using the European Society of Cardiology 2022 guidelines. There were no fatal symptoms or death due to myocarditis. The median time to the onset of myocarditis was 25 days (21–86 days). The early detection of myocarditis caused by this therapy requires the monitoring of changes by periodically measuring hsTn and other cardiac markers and performing ECGs and echocardiography from the early stages of administration through to the end of treatment. In addition to checking symptoms, if these abnormalities are detected and myocarditis is suspected, prompt collaboration with cardiologists is recommended. Our management strategy of care by a onco-cardiology team may contribute to the early diagnosis and treatment of myocarditis.https://doi.org/10.1007/s00262-025-03945-0Nivolumab and ipilimumabRenal cell carcinomaMyocarditisHigh-sensitivity TroponinOnco-cardiology team |
| spellingShingle | Maki Todo Yodo Gatate Shintaro Nakano Go Kaneko Masayuki Hagiwara Takayuki Takahashi Yuta Umezawa Genji Ueda Shiho Ishikawa Yoshinori Makino Masafumi Oyama Suguru Shirotake Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma Cancer Immunology, Immunotherapy Nivolumab and ipilimumab Renal cell carcinoma Myocarditis High-sensitivity Troponin Onco-cardiology team |
| title | Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma |
| title_full | Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma |
| title_fullStr | Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma |
| title_full_unstemmed | Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma |
| title_short | Early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma |
| title_sort | early detection of myocarditis caused by immune checkpoint inhibitor therapy with nivolumab and ipilimumab for advanced recurrent renal cell carcinoma |
| topic | Nivolumab and ipilimumab Renal cell carcinoma Myocarditis High-sensitivity Troponin Onco-cardiology team |
| url | https://doi.org/10.1007/s00262-025-03945-0 |
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