Conclusions/Future Directions
It is important to have a high clinical suspicion for irAEs in those undergoing treatment with novel immunotherapies for their malignancies. These therapies are promising and provide hope for an improved length of survival and quality of life in those with otherwise poor outcomes, however their associated toxicities, which manifest as irAEs may be fatal. Immunotherapy related cardiac toxicity is an important albeit rare sequalae of immune checkpoint inhibitor therapy. Further studies are needed to evaluate the risks and benefits of staggered induction therapy, as has been studied in melanoma, as well as dosing manipulation to reduce the effects of combined drug therapy.82 As more cases of irAEs are reported, it will be important not only to determine the underlying genetic determinants that predispose to irAEs, in order to specific tailor therapy to the patients individual genetic predisposition, but also to longitudinally follow these patients to determine resolution of these presentations and their effects on outcomes.
Funding: None
Disclosure statement: The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patient-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Institutional Review Board approval was not sought as this represents a single case and did not involve human subject research. Ethics approval was not sought as care provided was considered to be standard of care with no ethical dilemmas noted.