Cardiovascular complications of immune checkpoint inhibitors

Cardiovascular toxicity of cancer therapies remains an urgent problem today. The creation of highly effect antitumor drugs also means the appearance of new adverse effects. Immune checkpoint inhibitors (ICI) is a new class of antitumor drugs that is different from traditional chemotherapeutic and targeted drugs. Immunotherapy with ICI (monoclonal antibodies targeting the cytotoxic T-lymphocyte associated antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1) or its ligand (PD-L1)) significantly improved the results of treatment of cancer therapy. These drugs regulate antitumor immunity and promote cancer regression and improve survival, but can also cause a wide range of immunity-related adverse events (AEs). Although cardiotoxicity associated with ICI is rare, it is important because of its high mortality rates. In recent years, cases of myocarditis and fatal heart failure have been recorded more often in patients receiving ICI. This review focuses on the mechanisms of cardiotoxicity, methods for the prevention and treatment of these adverse events. Severe cardiovascular consequences associated with the use of ICI are important issues for oncologists, cardiologists and immunologists.