Cardiac Challenges in Immune Checkpoint Therapy: Complete Heart Block With Pembrolizumab

TL;DR

This paper reports a case where pembrolizumab, an immune therapy drug, caused severe heart problems in a cancer patient, emphasizing the need for careful monitoring.

Contribution

The novelty lies in highlighting complete heart block as a rare but severe cardiac complication of pembrolizumab therapy.

Findings

A patient developed complete heart block and ventricular arrhythmias after pembrolizumab therapy.

The patient's condition worsened rapidly despite no signs of myocarditis.

The case emphasizes the importance of managing cardiotoxicity in ICI therapy.

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, yet they come with a spectrum of immune-related adverse events, including cardiac complications. We present the case of a 72-year-old male with metastatic renal cell carcinoma who developed complete heart block and ventricular arrhythmias following pembrolizumab therapy. Despite no evidence of myocarditis, the patient's condition rapidly deteriorated, ultimately resulting in his demise. This case underscores the critical need for vigilance in recognizing and managing potential cardiotoxicity associated with ICIs. Additionally, it highlights the importance of multidisciplinary collaboration in optimizing diagnostic and therapeutic strategies for patients undergoing immune checkpoint inhibitor therapy.

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