Table 3

Outcome of the six patients ICI-rechallenged after myocarditis occurrence


Sex / ageCancerInitial ICIMyocarditisTreat-mentICI rechallengeOutcome after ICI rechallenge
Time to onset (d)BonacaDiagnosisSeverityTime (d)ICIMyocarditis relapseNew irAEsTTP
(d)
Follow-up (d)Death*
1M / 54MelanomaCTLA-4+PD-163ProElevation of troponin + clinical syndrome + ECG + decline in systolic functionClinically significantGC112PD-17208300
2M / 71NSCLCPD-164DefPathologySevereGC14PD-11803251
3F / 53MelanomaCTLA-4+PD-146PosElevation of troponin + clinical syndrome + concomitant myositisClinically significantGC; IVIg; MTX; PLEx140PD-1902881
4F / 69MelanomaCTLA-4+PD-121PosElevation of troponin + clinical syndrome + ECG + negative angiographyClinically significantGC42PD-1458070
5M / 71MelanomaCTLA-4+PD-139ProElevation of troponin + clinical syndrome + ECG + elevated T2m on CMRClinically significantGC28PD-1568110
6M / 72NSCLCPD-158PosElevation of troponin + clinical syndrome + ECG + negative angiographyClinically significant150PD-1+281831
  • *All deaths were caused by cancer progression.

  • †Clinically significant, treated with glucocorticoids with favorable outcome.

  • CMR, cardiac magnetic resonance; CTLA-4, cytotoxic T-lymphocyte-associated antigen-4; d, days; Def, definite; GC, glucocorticoids; ICI, immune checkpoint inhibitor; irAEs, immune-related adverse events; IVIg, intravenous immunoglobulins; MTX, methotrexate; NSCLC, non-small-cell lung cancer; PD-1, programmed-death 1; PLEx, plasma exchange; Pos, possible; Pro, probable; TTP, time to progression.