Presentation

Cancer immunotherapies have transformed antineoplastic treatments by targeting key regulators of the immune response, including CTLA-4, PD-1, and PD-L1. Monoclonal antibodies directed against these immune checkpoints unleash anti-tumor immunity, leading to tumour cell death through cytolytic molecules. However, the use of immune checkpoint inhibitors (ICIs), either alone or in combination, can disrupt immunologic tolerance, resulting in a spectrum of immune-related adverse events (irAEs).

The precise incidence of cardiac irAEs due to ICIs remains uncertain, though current estimates suggest it to be less than 1% of patients. Early symptoms of ICI-associated myocarditis typically manifest within a median of 30 days after initial exposure to ICI, with a mortality rate of up to 50%. Late cardiovascular events (>90 days) are less well-characterised but often entail a higher risk of non-inflammatory heart failure (HF), progressive atherosclerosis, hypertension, and increased mortality.

Factors predisposing patients to heightened baseline ICI-related cardiovascular toxicity risk include dual ICI therapy (e.g., ipilimumab and nivolumab), combination ICI therapy with other cardiotoxic agents, and a history of ICI-related non-cardiovascular events or prior cardiovascular disease.

With the field of Cardio-Immuno-Oncology continuously evolving, our Study Group endeavours to organise workshops to delve into the elusive mechanisms of cardiac irAEs and address emerging clinical scenarios and challenges.

Obejctives

Thanks to the expertises and backgrounds of its members, the WG's objectives are:

• Dissecting mechanisms and pathophysiology that involve the role of the immune system at the intersection of cancer, the heart, and anticancer treatments
• Unveiling and assessing different clinical toxicities within the spectra of cardiotoxicities induced by immunotherapies.

Members

Chair: Associate Professor Carlo Gabriele Tocchetti
Secretary: Doctor Pilar Martin
Committee member: Professor Tienush Assaf
Committee member: Doctor Javid Moslehi
Committee member: Doctor Joe Elie Salem
Committee member: Doctor Tomas Neilan
Committee member: Doctor Maria Sol Andres
Committee member: Doctor Yvonne Koop
Committee member: Miss Jennifer Cautela
Committee member: Doctor Kate Yung
Committee member: Doctor Massimiliano Camilli