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Successful Treatment of Steroid-Refractory Checkpoint Inhibitor Myocarditis with Globulin Derived-Therapy: A Case Report and Literature Review

2021; Elsevier BV; Volume: 362; Issue: 4 Linguagem: Inglês

10.1016/j.amjms.2021.04.018

1538-2990

Timothy Barry, Rory Gallen, Catherine Freeman, Pradyumna Agasthi, Dawn Pedrotty, Ming Yang, Clinton Jokerst, Farouk Mookadam, Brian Hardaway, Lisa LeMond, Reza Arsanjani, Carolyn Larsen,

Viral Infections and Immunology Research

Immune checkpoint inhibitor (ICI) monoclonal antibody drugs are an important interface of immunology and cancer biology with the intended goal to create cancer specific treatments with less systemic toxicity. Recognition of immune-related adverse events is critical and these include significant cardiovascular toxicity and myocarditis. Compared with other immune-related events, ICI associated myocarditis is rare but is associated with high mortality. The majority of cases present early in the course of therapy and patients can rapidly progress to fulminant myocarditis. Initially, the mainstay of treatment in patients with ICI-associated myocarditis is immunosuppressive therapy with glucocorticoids. For those who do not respond to steroids, the optimal treatment is unclear. This review summarizes the potential adjunctive treatment options for patients with steroid-refractory myocarditis by illustrating a case of myocarditis that was treated with Thymoglobulin and immunoglobulin.