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Letter to the Editor| Volume 131, P5-8, May 2020

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Early detection and management of immune-related myocarditis: Experience from a case with advanced squamous cell lung carcinoma

  • Author Footnotes
    1 The authors contributed equally to this work.
    Li Tu
    Footnotes
    1 The authors contributed equally to this work.
    Affiliations
    Department of Medical Oncology, Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
    Search for articles by this author
  • Author Footnotes
    1 The authors contributed equally to this work.
    Jiewei Liu
    Footnotes
    1 The authors contributed equally to this work.
    Affiliations
    Department of Medical Oncology, Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
    Search for articles by this author
  • Zhixi Li
    Affiliations
    Department of Medical Oncology, Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
    Search for articles by this author
  • Yanyang Liu
    Affiliations
    Department of Medical Oncology, Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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  • Feng Luo
    Correspondence
    Corresponding author:
    Affiliations
    Department of Medical Oncology, Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
    Search for articles by this author
  • Author Footnotes
    1 The authors contributed equally to this work.
Published:April 02, 2020DOI:https://doi.org/10.1016/j.ejca.2020.02.046
Early detection and management of immune-related myocarditis: Experience from a case with advanced squamous cell lung carcinoma
Previous ArticleToxic epidermal necrolysis accompanied by several immune-related adverse events developed after discontinuation of nivolumab
Next ArticleImmune thrombocytopenia of haematological immune-related adverse events in cancer immunotherapy: Most and mighty
      Myocardial immune-related adverse effect is reported as less than 1% of immune-related adverse events but very high mortality about 50% [
      • Moslehi J.J.
      • Salem J.-E.
      • Sosman J.A.
      • Lebrun-Vignes B.
      • Johnson D.B.
      Increased reporting of fatal immune checkpoint inhibitor-associated myocarditis.
      Lancet. 2018; 391: 933
      ,
      • Salem J.-E.
      • Manouchehri A.
      • Moey M.
      • Lebrun-Vignes B.
      • Bastarache L.
      • Pariente A.
      • et al.
      Cardiovascular toxicities associated with immune checkpoint inhibitors: an observational, retrospective, pharmacovigilance study.
      Lancet Oncol. 2018; 19: 1579-1589
      ]. Some patients progress rapidly and even deteriorate from complaining of symptoms to life crisis only in 24–48 h. Thus, early detection and comprehensive management are extremely important for good prognosis. Presently, diagnostic tests include electrocardiogram (ECG), echocardiogram, myocardial biomarkers, cardiac magnetic resonance (CMR) and endomyocardial biopsy (EMB) [
      • Zhang L.
      • Jones-O’Connor Maeve
      • Awadalla M.
      • Zlotoff D.A.
      • Thavendiranathan P.
      • Groarke J.D.
      • et al.
      Cardiotoxicity of immune checkpoint inhibitors.
      Curr Treat Options Cardiovasc Med. 2019; 21: 32
      ]. CMR is a non-invasive gold-standard test for diagnosis, whereas EMB is an invasive one. However, it might be late to start treatment after diagnosis is confirmed by CMR or EMB, given the situation that immune-related myocarditis is a rapidly deteriorating disease with extremely high mortality. Therefore, ECG, echocardiogram and biomarkers could play more important roles in early detection. In some circumstances, diagnostic treatment is also crucial method. Here, we report a case detected by increasing myocardial biomarkers and defined by diagnostic treatment.

      Keywords

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      Article info

      Publication history

      Published online: April 02, 2020
      Accepted: February 13, 2020
      Received: December 16, 2019

      Identification

      DOI: https://doi.org/10.1016/j.ejca.2020.02.046

      Copyright

      © 2020 Elsevier Ltd. All rights reserved.

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