The development of immunotherapy in oncology field has revolutionized the prognosis of many types of cancer. The immune checkpoint inhibitors target receptors whose inhibition increases the activity of immune system cells against tumor cells. In recent years, new immunotherapies have been studied and approved in a growing number of tumors including melanoma, non-small cell lung cancer (NSCLC), and renal cell cancer (RCC). This volume provides a complete and updated state-of-art review regarding the management of cardiovascular toxicities from new immunotherapies. The manuscript is divided into different sections starting from the relationship between cancer and immune system to let the reader understand the new molecular concepts under immunotherapy development. Subsequent chapters describe specifically the immunotherapy options in solid tumor treatment and the main features of the immuno-related cardiovascular complications. This volume is written by experts in the oncological and cardiovascular fields and aims to provide to clinicians who approach current cancer patients a useful tool to move through the paths of modern cardio-oncology. An important section would afford the most relevant interventions needed to manage the cardiac events, suggesting how to reduce their impact and effects on oncological outcomes. The text concludes by addressing future perspectives in the cardio-immunology field, discussing many aspects such as the early detection of cardiovascular damage and the potential role of liquid biopsy in new damage-related biomarkers discovery.
Author(s): Antonio Russo, Nicola Maurea, Dimitrios Farmakis, Antonio Giordano
Series: Current Clinical Pathology
Publisher: Humana
Year: 2022
Language: English
Pages: 126
City: New York
Foreword
Preface
Acknowledgments
Contents
Contributors
1: Background: Immunology and Cancer
References
2: Available Immunotherapy Drugs in Oncology
Anti-PD-1 Agents
Pembrolizumab
Nivolumab
Anti-PD-L1 Agents
Atezolizumab
Durvalumab
Avelumab
Anti-CTLA4 Agents
Ipilimumab
References
3: Immunotherapy Adverse Events
Introduction
Myocarditis
Noninflammatory Myocardial Dysfunction
Arrhythmias
Pericardial Disease
Vasculitis
Myocardial Infarction
References
4: Pathophysiology of Cardiac Toxicity
Pathophysiology of Cardiac Toxicity: An Overview
Cardiac Dysfunction and Heart Failure
Vascular Disease
Arrhythmias
Pericardial and Valvular Disease
References
5: Cardiac Risk Factors for Immunotherapy
Why Evaluate the Cardiovascular Risk in Oncological Patients Who Have Undergone Immunotherapy?
How to Quantify Cardiovascular Risk?
Experimental Preventive Strategies for Immune Checkpoint Inhibitor (ICI)-Induced Cardiotoxicity: Evidence and Perspectives
References
6: Diagnostic Methods of Cardiac Immunotherapy Damaging
Introduction
Clinical and Electrocardiographic Evaluation
Echocardiography
Myocardial Deformation Imaging
Nuclear Imaging and Cardiac Magnetic Resonance
Role of Biomarkers
Role of Endomyocardial Biopsy
Diagnostic Approach
Conclusion
References
7: Biomarkers of Early Cardiotoxicity
Introduction
Cardiac Troponins
Brain Natriuretic Peptides
New Emerging Biomarkers
Conclusion
References
8: Management of Patients with Cardiac Toxicity: The Point of View of the Cardiologist
Introduction
Atherosclerosis and Cardiovascular Events
Myocarditis and Heart Failure
Clinical Presentation
Diagnosis
Management
ICI-Associated Pericarditis
Diagnosis
Management
Takotsubo Syndrome
Arrhythmias
Management
Immunotherapy-Associated Vasculitis
Immunotherapy-Associated Thromboembolism
Screening and Surveillance
Conclusion
References
9: Management of Patients with Cardiac Toxicity: The Point of View of the Oncologist
Introduction
Mechanisms of Action of Cardiovascular ICI Adverse Events
Myocarditis
Epidemiology
Physiopathology
Clinical Presentation
Laboratory and Imaging Findings
Diagnosis and Management
Pericarditis
Epidemiology
Pathophysiology
Clinical Presentation
Diagnosis
Management
Acute Coronary Syndrome (ACS) and Myocardial Infarction (MI)
Epidemiology
Physiopathology
Clinical Presentation
Diagnosis
Management
Takotsubo Cardiomyopathy
Epidemiology
Pathophysiology
Clinical Presentation
Diagnosis
Management
Dysrhythmias
Epidemiology
Pathophysiology
Diagnosis
Management
Vasculitis
Epidemiology
Pathophysiology
Clinical Presentation
Diagnosis
Management
Cardiotoxicity Related to New Immunotherapy (CAR T Cell)
Epidemiology
Pathophysiology
Diagnosis
Management
Baseline Assessment and General Principle of Management for Cardiovascular IRAE
Conclusion
References
10: Future Perspectives
Introduction
Basic and Translational Research
Clinical Research
Education and Training
Service Organization and Provision
References
Index
