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Javid Moslehi, MD - Updating Our Cardio-Oncology Skills in the Cancer Immunotherapy Era: Team-Based Strategies for Risk Assessment, Diagnosis, and Management of Myocarditis and Other Cardiac Immune-Related Adverse Events
Go online to PeerView.com/SFP860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Immune checkpoint inhibitors (ICIs) have had a strikingly positive impact on the treatment of a range of cancer types by blocking intrinsic downregulators of the immune response to increase antitumor immunity. A number of ICIs and ICI-based combinations have been approved for use in many solid and liquid malignancies, and intense research efforts promise to expand their role in advanced cancers and early-stage, curative-intent settings. While immunotherapy has become a pillar of cancer treatment and is considered safe, ICIs are associated with a spectrum of unique toxicities termed immune-related adverse events (irAEs). These irAEs can affect any organ system in the body, including the heart and cardiovascular system, occur at any point during or after treatment, and vary in presentation from mild to severe, and sometimes life threatening. Cardiac pathology attributed to irAEs include myocarditis, cardiomyopathy, pericardial disease, arrhythmias and conduction disease, impaired ventricular function with heart failure, and vasculitis. Autoimmune myocarditis is the most common and best characterized cardiac irAE to date. This activity, based on a PeerView Live Clinical Consults cardio-oncology symposium, provides essential guidance for prompt identification and initiation of treatment of irAEs. In the current era of cancer immunotherapy, healthcare professionals must develop a high level of vigilance and be able to correctly and rapidly manage and monitor patients with cancer exhibiting symptoms of possible cardiac irAEs to ensure the best possible outcomes. The expert faculty presents management algorithms, real-world case scenarios, and practical challenges related to multidisciplinary coordination of care to improve collaborative mitigation of cardiac irAEs. Upon completion of this activity, participants should be better able to: Review the prevalence, biologic mechanisms, burden, and consequences of the development of cardiac immune-related adverse events (irAEs) during or after treatment with cancer immunotherapies; Apply algorithms, practical tools, and available therapies based on the latest clinical evidence and recommendations for baseline risk assessment, identification, diagnosis/differential diagnosis, treatment, and management of cardiac irAEs; and Utilize effective shared decision-making and team-based approaches to facilitate multidisciplinary and interprofessional collaboration and improve clinician-patient communication and outcomes for patients at risk of or experiencing cardiac irAEs