Loading
Chemotherapy-induced Cardiotoxicity and Mitigation · Journal article
Cardio-oncology · September 2, 2026
Encouraging direction, but not yet definitive.
This prospective single-centre cohort study of 175 consecutive patients referred for suspected CV irAEs identifies predictors of mid-term CV events and describes outcomes after ICI rechallenge. Among 84 rechallenged patients, 3 (3.6%) developed non-severe myocarditis with no ICU admissions or CV deaths, but significant coronary stenosis, hospital admission, ICI rechallenge, and positive Lake Louise CMR were associated with higher CV event risk.
Prospective single-centre cohort study. Consecutive adults referred for suspected cardiovascular immune-related adverse events; median age 61 years (IQR 48–72); 77.1% women; all receiving immune-checkpoint inhibitors for cancer.. Intervention: ICI rechallenge in 84 patients (48.0% of cohort); specific ICI agents and rechallenge protocols not detailed in abstract. Compared with: Patients not rechallenged (91 patients); patients without adjudicated initial CV irAEs (80 patients). n = 175. Single centre (location not specified in abstract).
175 patients enrolled; 95 (54.3%) had adjudicated CV irAEs including 72 (41.1%) with non-severe ICI-myocarditis criteria During 234 ± 154 days follow-up, 15 patients died (12 cancer-related, 1 CV, 2 other) ICI rechallenge was performed in 84 patients (48.0%); 3 (3.6%) developed non-severe myocarditis with no ICU admissions or CV deaths
Absolute CV event rates and mortality by risk strata not fully stratified in abstract
This study provides reassurance that ICI rechallenge in carefully selected patients with suspected or adjudicated CV irAEs has a low rate of recurrent myocarditis (3.6%), with no severe outcomes reported. However, the identified risk factors—particularly positive Lake Louise CMR (HR 18.84) and coronary stenosis (HR 4.77)—should guide patient selection and monitoring strategies during rechallenge.
A prospective single-centre cohort study with adjudicated endpoints and identified predictors of mid-term CV events, but limited by single-centre design and lack of a comparator arm, providing real results that require confirmation in larger populations.
As stated by the source record.
Quoted from the source exactly as published.
This study provides reassurance that ICI rechallenge in carefully selected patients with suspected or adjudicated CV irAEs has a low rate of recurrent myocarditis (3.6%), with no severe outcomes reported. However, the identified risk factors—particularly positive Lake Louise CMR (HR 18.84) and coronary stenosis (HR 4.77)—should guide patient selection and monitoring strategies during rechallenge.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background Current European Society of cardiology guidelines recommend systematic troponin screening to detect potential cardiovascular (CV) immune-related adverse events (irAEs) in the increasing numbers of cancer patients receiving immune-checkpoint inhibitors (ICIs), increasing the number of patients referred and broadening the severity spectrum of CV irAEs. Management and outcomes in patients with suspected CV irAEs, are poorly defined. The safety of ICI rechallenge, particularly in patients fulfilling contemporary ICI-myocarditis diagnostic criteria, remains uncertain. Methods Prospective single-centre cohort including consecutive adults referred for suspected CV irAEs. Objectives were to describe outcomes after initial assessment, identify predictors of mid-term CV events, and evaluate outcomes of ICI rechallenge in patients with and without initial CV irAEs. Results Among 175 patients (median age 61 years [IQR 48–72]; 77.1% women), 95 (54.3%) had adjudicated CV irAEs at referral, including 72 (41.1%) fulfilling diagnostic criteria for non-severe ICI-myocarditis. During 234 ± 154 days of follow-up, 15 patients died (12 cancer-related, 1 CV, 2 other). Predictors of CV events included significant coronary stenosis (HR 4.77; 95% CI 1.39–16.40; P = 0.013), hospital admission (HR 13.21; 95% CI 2.51–69.52; P = 0.0023), ICI rechallenge (HR 9.30; 95% CI 1.77–48.77; P = 0.0084), and positive Lake Louise cardiac magnetic resonance (CMR) (HR 18.84; 95% CI 5.13–69.20; P < 0.0001). Eighty-four patients (48.0%) were rechallenged; 3 (3.6%) developed non-severe myocarditis, with no ICU admissions or CV deaths. Ten out of 53 (18.87%) patients without initial CV irAEs who continued ICIs developed CV events. Trial Registration NCT05799898
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.