Equine anti-thymocyte globulin could be an option for immunotherapy-related myocarditis
medwireNews: Treatment with equine anti-thymocyte globulin (ATG) could be an option for patients with cancer who develop immune-mediated myocarditis as a side effect of immune checkpoint inhibitor therapy.
The Australian researchers, who describe the first such successful case in the British Journal of Cancer, explain that steroids are the current mainstay for the treatment of immunotherapy-related toxicities, including the rare, but often fatal, incidences of immune-mediated myocarditis.
But they believe that ATG “should be considered” for steroid-refractory cases and “administered in close consultation with a cardiac transplant team experienced in the use of this agent.”
The patient – a 64-year-old woman with IDH-wild-type glioblastoma – developed malignant arrhythmias secondary to severe immune-mediated myocarditis during treatment with nivolumab, temozolomide, and radiation.
Her condition deteriorated despite receiving high-dose corticosteroids and therefore, she was given equine ATG, which led to clinical and biochemical improvements within 3 days of administration.
Lead author Andrew Haydon (Alfred Health, Melbourne, Victoria) and team ascribe the favorable outcome to “the administration of ATG given the temporal relationship between the time of infusion and clinical improvement.”
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