Successful Treatment of Steroid-Refractory Checkpoint Inhibitor Myocarditis with Globulin Derived-Therapy: A Case Report and Literature Review

Timothy Barry, Rory Gallen, Catherine Freeman, Pradyumna Agasthi, Dawn Pedrotty, Ming Yang, Clinton E. Jokerst, Farouk Mookadam, Brian W. Hardaway, Lisa LeMond, Reza Arsanjani, Carolyn Larsen

Research output: Contribution to journalReview articlepeer-review

Abstract

Immune checkpoint inhibitor (ICI) monoclonal antibody drugs are an important interface of immunology and cancer biology with the intended goal to create cancer specific treatments with less systemic toxicity. Recognition of immune-related adverse events is critical and these include significant cardiovascular toxicity and myocarditis. Compared with other immune-related events, ICI associated myocarditis is rare but is associated with high mortality. The majority of cases present early in the course of therapy and patients can rapidly progress to fulminant myocarditis. Initially, the mainstay of treatment in patients with ICI-associated myocarditis is immunosuppressive therapy with glucocorticoids. For those who do not respond to steroids, the optimal treatment is unclear. This review summarizes the potential adjunctive treatment options for patients with steroid-refractory myocarditis by illustrating a case of myocarditis that was treated with Thymoglobulin and immunoglobulin.

Original languageEnglish (US)
Pages (from-to)424-432
Number of pages9
JournalAmerican Journal of the Medical Sciences
Volume362
Issue number4
DOIs
StatePublished - Oct 2021

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