THURSDAY, March 2, 2023 (HealthDay News) -- A strategy including identification of severe immune checkpoint inhibitor (ICI)-related myocarditis based on screening combined with active ventilation and treatment seems beneficial for reducing the myotoxicity-related fatality rate, according to a study published online Feb. 23 in Cancer Discovery.
Joe-Elie Salem, M.D., Ph.D., from Sorbonne Université in Paris, and colleagues reported results of a strategy including screening for and managing concomitant respiratory muscle involvement with mechanical ventilation and treatment with abatacept and ruxolitinib for individuals with severe ICI-myocarditis. Data were included for 40 patients with definite ICI-myocarditis; the first 10 were treated using recommended guidelines, while the subsequent 30 patients underwent systematic screening for respiratory muscle involvement as well as active ventilation and treatment with ruxolitinib and abatacept.
The researchers found that myotoxicity-related fatality occurred in 60 percent of the first 10 patients. In the subsequent 30 patients, abatacept dose was adjusted based on CD86-receptor occupancy on circulating monocytes. In these patients, the myotoxicity-related fatality rate was 3.4 percent.
"While this is not a randomized clinical trial, the significant improvement in outcomes when patients are treated with targeted therapies is very suggestive that this regimen is helpful," Salem said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry; several authors have patents related to the treatment of ICI-related immune adverse events.