A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers

Immune checkpoint inhibitor (ICI) have demonstrated efficacy in treating various cancers by modulating the immune system, but this can lead to immune-related adverse events (irAEs), including myocarditis. ICI-associated myocarditis is a rare but highly lethal irAE with a short mean time to onset, an...

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Main Authors: Le Xu, Yukai Chen, Lin Xiong, Yang Shen, Zhuolin Zhou, Siyu Wang, Ximing Xu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Human Vaccines & Immunotherapeutics
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Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2025.2512645
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author Le Xu
Yukai Chen
Lin Xiong
Yang Shen
Zhuolin Zhou
Siyu Wang
Ximing Xu
author_facet Le Xu
Yukai Chen
Lin Xiong
Yang Shen
Zhuolin Zhou
Siyu Wang
Ximing Xu
author_sort Le Xu
collection DOAJ
description Immune checkpoint inhibitor (ICI) have demonstrated efficacy in treating various cancers by modulating the immune system, but this can lead to immune-related adverse events (irAEs), including myocarditis. ICI-associated myocarditis is a rare but highly lethal irAE with a short mean time to onset, and difficult to diagnose early due to nonspecific symptoms and lack of biomarkers. This review highlights the need for improved recognition and management of ICI-associated myocarditis, summarizing recent advances in immunology, pathology, and biomarker research. We discuss the epidemiology, clinical features, immunological mechanisms, and roles of biomarkers in diagnosis and risk stratification. Traditional biomarkers like cTnI and hs-cTnT are sensitive but lack specificity, while emerging biomarkers like miR-155 show tissue specificity. Inflammatory markers such as NLR and CRP aid prognosis but have limited diagnostic value.
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institution Kabale University
issn 2164-5515
2164-554X
language English
publishDate 2025-12-01
publisher Taylor & Francis Group
record_format Article
series Human Vaccines & Immunotherapeutics
spelling doaj-art-3cb5e7efb12d4fa289e1aa0dfc7f68c52025-08-20T03:44:51ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2512645A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkersLe Xu0Yukai Chen1Lin Xiong2Yang Shen3Zhuolin Zhou4Siyu Wang5Ximing Xu6Cancer Center, Renmin Hospital of Wuhan University, Wuhan, ChinaCancer Center, Renmin Hospital of Wuhan University, Wuhan, ChinaPathology Department, Renmin Hospital of Wuhan University, Wuhan, ChinaCancer Center, Renmin Hospital of Wuhan University, Wuhan, ChinaCancer Center, Renmin Hospital of Wuhan University, Wuhan, ChinaCancer Center, Renmin Hospital of Wuhan University, Wuhan, ChinaCancer Center, Renmin Hospital of Wuhan University, Wuhan, ChinaImmune checkpoint inhibitor (ICI) have demonstrated efficacy in treating various cancers by modulating the immune system, but this can lead to immune-related adverse events (irAEs), including myocarditis. ICI-associated myocarditis is a rare but highly lethal irAE with a short mean time to onset, and difficult to diagnose early due to nonspecific symptoms and lack of biomarkers. This review highlights the need for improved recognition and management of ICI-associated myocarditis, summarizing recent advances in immunology, pathology, and biomarker research. We discuss the epidemiology, clinical features, immunological mechanisms, and roles of biomarkers in diagnosis and risk stratification. Traditional biomarkers like cTnI and hs-cTnT are sensitive but lack specificity, while emerging biomarkers like miR-155 show tissue specificity. Inflammatory markers such as NLR and CRP aid prognosis but have limited diagnostic value.https://www.tandfonline.com/doi/10.1080/21645515.2025.2512645BiomarkersirAEsimmune checkpoint inhibitorsmyocarditispharmacology
spellingShingle Le Xu
Yukai Chen
Lin Xiong
Yang Shen
Zhuolin Zhou
Siyu Wang
Ximing Xu
A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers
Human Vaccines & Immunotherapeutics
Biomarkers
irAEs
immune checkpoint inhibitors
myocarditis
pharmacology
title A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers
title_full A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers
title_fullStr A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers
title_full_unstemmed A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers
title_short A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers
title_sort review of immune checkpoint inhibitor associated myocarditis epidemiology pathogenesis and biomarkers
topic Biomarkers
irAEs
immune checkpoint inhibitors
myocarditis
pharmacology
url https://www.tandfonline.com/doi/10.1080/21645515.2025.2512645
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