Cardiotoxicity associated with CTLA4 and PD1 blocking immunotherapy

Journal article

Publication Details

Author(s): Heinzerling L, Ott PA, Hodi FS, Husain AN, Tajmir-Riahi A, Tawbi H, Pauschinger M, Gajewski TF, Lipson EJ, Luke JJ
Journal: Journal for ImmunoTherapy of Cancer
Publication year: 2016
Volume: 4
ISSN: 2051-1426


Immune-checkpoint blocking antibodies have demonstrated objective antitumor responses in multiple tumor types including melanoma, non-small cell lung cancer (NSCLC), and renal cell cancer (RCC). In melanoma, an increase in overall survival has been demonstrated with anti-CTLA-4 and PD-1 inhibition. However, a plethora of immune-mediated adverse events has been reported with these agents. Immune-mediated cardiotoxicity induced by checkpoint inhibitors has been reported in single cases with variable presentation, including myocarditis and pericarditis. Among six clinical cancer centers with substantial experience in the administration of immune-checkpoint blocking antibodies, eight cases of immune-related cardiotoxicity after ipilimumab and/or nivolumab/pembrolizumab were identified. Diagnostic findings, treatment and follow-up are reported. A large variety of cardiotoxic events with manifestations such as heart failure, cardiomyopathy, heart block, myocardial fibrosis and myocarditis was documented. This is the largest case series to date describing cardiotoxicity of immune-checkpoint blocking antibodies. Awareness, monitoring of patients with pre-existing cardiac disorders and prompt evaluation by the treatment team is essential. Treatment including application of steroids is critical for patient safety.

FAU Authors / FAU Editors

Heinzerling, Lucie Prof. Dr.
Tajmir-Riahi, Azadeh Dr.

External institutions with authors

Dana–Farber Cancer Institute
Johns Hopkins University
Paracelsus Medizinische Privatuniversität, Nürnberg
University of Chicago
University of Texas MD Anderson Cancer Center

How to cite

Heinzerling, L., Ott, P.A., Hodi, F.S., Husain, A.N., Tajmir-Riahi, A., Tawbi, H.,... Luke, J.J. (2016). Cardiotoxicity associated with CTLA4 and PD1 blocking immunotherapy. Journal for ImmunoTherapy of Cancer, 4.

Heinzerling, Lucie, et al. "Cardiotoxicity associated with CTLA4 and PD1 blocking immunotherapy." Journal for ImmunoTherapy of Cancer 4 (2016).


Last updated on 2018-07-11 at 13:08