Ankit Mangla, Co-Director Melanoma, Cutaneous Oncology, and Sarcoma Disease team at University Hospitals Seidman Cancer Center, shared a post on LinkedIn about a paper he co-authored with colleagues published in Case Reports in Oncological Medicine:
“Interesting case we encountered in our Melanoma Clinics at University Hospitals Seidman Cancer Centre.
Patient with extensive cardiac history received Opdualag in the neoadjuvant setting and developed Myopericarditis like features. The MRI showed apical ballooning with echocardiographic features mimicking Takotsubo Cardiomyopathy (TTC).
TTC has been reported with the use of checkpoint inhibitors, but the causal relationship/mechanism remains elusive.
Also, if we are noticing inflammation in the cardiac muscle, then why call it TTC? We report that TTC like picture may just be a variance in the presentation of myocarditis. However, there is translation evidence to support the interaction between stress (induced by using isoproterenol) leading to increased expression of PD-1 and PDL1 in the immune cells residing in the myocardium.
Corticosteroids still play the main role in reversing this condition and should not be delayed even if the picture “mimics” TTC.
Interesting sequence of events reported here with long term remission and major pathologic response achieved with a single dose of Opdualag. Read on!”
Title: Myocarditis Mimicking Takotsubo Cardiomyopathy With First Dose of Neoadjuvant Nivolumab–Relatlimab
Authors: Rohit Rao, Felicia Tejawinata, Tejasi Sachdeva, Imran Rashid, Michael Zacharias, Jessica Siegel, McKay Herpel, Akihiro Yoshida, Luke D. Rothermel, Iris Y. Sheng, Ankit Mangla
You can read the full article in Case Reports in Oncological Medicine.
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