Immune Checkpoint Inhibitor-Mediated Cardiovascular Disease: The Dark Side of the Monoclonal Anti-Body Therapy against Cancer

Immune check point inhibitors (ICIs) are monoclonal antibodies (MOABs), that release the brake on T cell activation, thus, leading to an efficient killing of cancer cells [1-3]. Different types of ICIs are available, and comprise MOABs directed against programmed cell death protein (PD-1), its associated ligand (PDL-1) or cytotoxic T-lymphocyte antigen-4 (CTLA-4), which represent co-inhibitors immune check points, thus, blocking the T-cell mediated anti-tumor response [4]. However, ICI treatment implies several immune-related adverse events, and, among them, coronary artery disease, fatal myocarditis, pericardial disease, fibrosis, and heart failure have been reported [6,7]. Pros and cons of this novel therapy are highlighted in this perspective.