Fulminant myocarditis caused by immune checkpoint inhibitor: a case report and possible treatment inspiration

Abstract

Immune checkpoint inhibitors (ICIs) have become a new hope for many patients with advanced cancer by blocking tumour immune evasion. However, with the widespread use of ICIs, immune-related adverse events (irAEs) have also been discovered and reported increasingly. Immune-related myocarditis, the most dangerous one of irAEs, still has high mortality in the context of the current treatment. We report the case of a 60-year-old female with fulminant myocarditis induced by ICIs, which caused her to experience frequent ventricular arrhythmias such as ventricular fibrillation and heart failure. She was successfully treated with current mainstream therapies for immune-related myocarditis and additional treatment of sacubitril-valsartan and dapagliflozin. The intriguing observation that the patient condition recovered relatively rapidly in this case shows a possible treatment inspiration, which may be helpful for treating ICIs-associated myocarditis and improving cancer patients' clinical prognosis.

Lethal Immune Myocarditis and Myasthenia Gravis Due to Anti-PD-1 Treatment for a Bladder Cancer Patient: A Case Report and Possible Treatment Inspiration

“…Previous studies have shown that sacubitril/valsartan (an angiotensin receptor neoplasia inhibitor) improves cardiovascular risk, sudden death, or reduced ejection fraction (HFrEF) in heart failure. 17 Therefore, we simultaneously administered sacubitril/valsartan. Unfortunately, the patient’s condition did not improve.…”