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A case of subclinical immune checkpoint inhibitor-associated myocarditis in non-small cell lung cancer

Yue Hu, Cuixia Liu, Shaojun Jin, Zihan Yi, Chao Wang, Xiaohong Pan, Huaqiong Huang

2023BMC Pulmonary Medicine14 citationsDOIOpen Access PDF

Abstract

BACKGROUND: Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of cancer. Moreover, immune-related adverse events (irAEs) have become a new clinical challenge. ICI-associated myocarditis is a rare but fatal condition among diverse organ injuries, and early recognition and effective interventions are critical for patients. CASE PRESENTATION: In this report, we present the case of a healthy 60-year-old male who was diagnosed with lung squamous cell carcinomas following chemotherapy and received ICIs. The patient presented with asymptomatic cardiac biomarker elevation followed by immune-related myocarditis. Fortunately, the patient achieved a good clinical result after receiving high-dose steroids. The treatment with ICIs was discontinued because of recurrent increases in troponin T. CONCLUSION: ICI-mediated associated myocarditis is an uncommon but potentially life-threatening adverse event. The current data suggest that clinicians need to be cautious about reinitiation in low-grade patients; however, further study of the diagnosis and treatment is necessary.

Topics & Concepts

MedicineSubclinical infectionMyocarditisLung cancerNivolumabImmune systemLungCancerImmunologyImmune checkpointOncologyImmunotherapyInternal medicineCancer Immunotherapy and BiomarkersChemotherapy-induced cardiotoxicity and mitigationLung Cancer Diagnosis and Treatment