Approaches to Diagnosing and Managing Myocarditis Related to Immunotherapy

EP: 1.An Overview of the Landscape Surrounding Melanoma

EP: 2.The Role of Biomarker Testing in Melanoma

EP: 3.The Current Landscape Surrounding Adjuvant Therapy in Melanoma

EP: 4.Combination Immunotherapy Strategies for Melanoma in the Adjuvant Setting

EP: 5.Navigating Challenges in Predicting and Mitigating Adverse Events in Adjuvant Immunotherapy

EP: 6.Exploring Immunotherapy Resistance: Impact on Treatment Decisions in Melanoma

EP: 7.Balancing Quality of Life: Adjuvant Therapy Toxicity in Melanoma Adjuvant Immunotherapy

EP: 8.Case 1: Man Aged 55 Years With Stage IIIB Melanoma Developing Immunotherapy-Induced Diabetes

EP: 9.Immunotherapy-Related Diabetes in Melanoma: A Management Perspective

EP: 10.Immunotherapy-Induced Adrenal Insufficiency in Melanoma: Surveillance and Management

EP: 11.Case 2: 63-Year-Old Female Patient With Metastatic Melanoma on Dual Immunotherapy Developing Treatment-Related Myocarditis

Now Viewing

EP: 12.Approaches to Diagnosing and Managing Myocarditis Related to Immunotherapy

EP: 13.Expert Perspectives on Cardiac Baseline and Surveillance Testing in Immunotherapy Recipients

EP: 14.Corticosteroid Treatment Challenges in Patients with Immunotherapy-Related Toxicities

EP: 15.Forward Outlook and Clinical Insights in Melanoma Treatment

This is a video synopsis/summary of an OncLive Insights involving Afreen Shariff, MD, MBBS; Javid Moslehi, MD; and Nikhil Khushalani, MD.

To evaluate suspected immune checkpoint inhibitor (ICI) myocarditis, Dr Moslehi recommends a thorough history/physical, EKG, cardiac biomarkers like troponin and creatinine kinase, and echocardiogram, though ejection fraction may be normal. Further workup includes cardiac MRI, myocardial biopsy, and angiography to rule out heart attack. He advises admitting under telemetry monitoring and early cardiology involvement.

Regarding treatment, Dr Moslehi states steroids are commonly used in the first line, though optimal dosing remains unclear. Other immunosuppressive agents like the T-cell inhibitor abatacept and Janus kinase inhibitor ruxolitinib have shown mortality benefit in small studies and may precision-target myocardial inflammation pathways. However, controlled trials are still needed.

Dr Khushalani summarizes the key takeaways as having high suspicion for myocarditis, getting specialized cardiac diagnostics quickly, using high-dose steroids, and considering newer precision immunotherapy approaches.

Video synopsis is AI-generated and reviewed by OncLive^® editorial staff.