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
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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’
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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.