Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review

Immune checkpoint inhibitors (ICIs) therapy has revolutionized cancer treatment. However, it is important to acknowledge that ICI therapy can lead to immune-related adverse events (irAEs), including myocarditis. While early-onset myocarditis is well-documented, late-onset cases are increasingly reco...

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Main Authors: Harun Muğlu, Erdem Sünger, Bahadır Köylü, Didem Tunalı, Cengiz Erol, Fatih Selcukbiricik, Ahmet Bilici, Omer Fatih Olmez
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/2/302
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author Harun Muğlu
Erdem Sünger
Bahadır Köylü
Didem Tunalı
Cengiz Erol
Fatih Selcukbiricik
Ahmet Bilici
Omer Fatih Olmez
author_facet Harun Muğlu
Erdem Sünger
Bahadır Köylü
Didem Tunalı
Cengiz Erol
Fatih Selcukbiricik
Ahmet Bilici
Omer Fatih Olmez
author_sort Harun Muğlu
collection DOAJ
description Immune checkpoint inhibitors (ICIs) therapy has revolutionized cancer treatment. However, it is important to acknowledge that ICI therapy can lead to immune-related adverse events (irAEs), including myocarditis. While early-onset myocarditis is well-documented, late-onset cases are increasingly recognized. This case series presents four cases of late-onset ICI-associated myocarditis, emphasizing the need for long-term surveillance of this potentially fatal complication. Patients exhibited a range of cardiac symptoms, including chest pain, shortness of breath, and arrhythmias. The diagnosis was confirmed through cardiac magnetic resonance imaging (MRI) and elevated cardiac biomarkers. Treatment involved the immediate discontinuation of ICI therapy and the initiation of high-dose corticosteroids. In cases with an inadequate response, additional immunosuppressive agents were considered. This case series underscores the importance of prolonged monitoring for late-onset ICI-associated myocarditis. Further research is needed to establish optimal treatment strategies and long-term management approaches for this complex condition.
format Article
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institution OA Journals
issn 1010-660X
1648-9144
language English
publishDate 2025-02-01
publisher MDPI AG
record_format Article
series Medicina
spelling doaj-art-507fcbc6961d4a5e96589443358d85df2025-08-20T02:03:40ZengMDPI AGMedicina1010-660X1648-91442025-02-0161230210.3390/medicina61020302Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature ReviewHarun Muğlu0Erdem Sünger1Bahadır Köylü2Didem Tunalı3Cengiz Erol4Fatih Selcukbiricik5Ahmet Bilici6Omer Fatih Olmez7Department of Medical Oncology, Faculty of Medicine, Medipol University, Istanbul 34214, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Medipol University, Istanbul 34214, TurkeyDepartment of Medical Oncology, Istanbul Koc University, Istanbul 34450, TurkeyDepartment of Medical Oncology, Istanbul Koc University, Istanbul 34450, TurkeyDepartment of Radiology, Faculty of Medicine, Medipol University, Istanbul 34214, TurkeyDepartment of Medical Oncology, Istanbul Koc University, Istanbul 34450, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Medipol University, Istanbul 34214, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Medipol University, Istanbul 34214, TurkeyImmune checkpoint inhibitors (ICIs) therapy has revolutionized cancer treatment. However, it is important to acknowledge that ICI therapy can lead to immune-related adverse events (irAEs), including myocarditis. While early-onset myocarditis is well-documented, late-onset cases are increasingly recognized. This case series presents four cases of late-onset ICI-associated myocarditis, emphasizing the need for long-term surveillance of this potentially fatal complication. Patients exhibited a range of cardiac symptoms, including chest pain, shortness of breath, and arrhythmias. The diagnosis was confirmed through cardiac magnetic resonance imaging (MRI) and elevated cardiac biomarkers. Treatment involved the immediate discontinuation of ICI therapy and the initiation of high-dose corticosteroids. In cases with an inadequate response, additional immunosuppressive agents were considered. This case series underscores the importance of prolonged monitoring for late-onset ICI-associated myocarditis. Further research is needed to establish optimal treatment strategies and long-term management approaches for this complex condition.https://www.mdpi.com/1648-9144/61/2/302immune checkpoint inhibitorsimmune-related adverse events (irAEs)late-onset myocarditiscardiotoxicity
spellingShingle Harun Muğlu
Erdem Sünger
Bahadır Köylü
Didem Tunalı
Cengiz Erol
Fatih Selcukbiricik
Ahmet Bilici
Omer Fatih Olmez
Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review
Medicina
immune checkpoint inhibitors
immune-related adverse events (irAEs)
late-onset myocarditis
cardiotoxicity
title Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review
title_full Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review
title_fullStr Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review
title_full_unstemmed Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review
title_short Late-Onset Myocarditis Following Immune Checkpoint Inhibitors Therapy: A Case Series with Literature Review
title_sort late onset myocarditis following immune checkpoint inhibitors therapy a case series with literature review
topic immune checkpoint inhibitors
immune-related adverse events (irAEs)
late-onset myocarditis
cardiotoxicity
url https://www.mdpi.com/1648-9144/61/2/302
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