Cancer immunotherapy significantly contributed to an improvement in the prognosis of
cancer patients.
Immunotherapy, including
human epidermal growth factor receptor 2 (HER2)-targeted
therapies,
immune checkpoint inhibitors (ICI), and
chimeric antigen receptor-modified T (CAR-T), share the characteristic to exploit the capabilities of the immune system to kill cancerous cells.
Trastuzumab is a
monoclonal antibody against HER2 that prevents HER2-mediated signaling; it is administered mainly in HER2-positive
cancers, such as breast, colorectal, biliary tract, and non-small-cell
lung cancers.
Immune checkpoint inhibitors (ICI) inhibit the binding of CTLA-4 or PD-1 to PDL-1, allowing T cells to kill cancerous cells. ICI can be used in
melanomas,
non-small-cell lung cancer, urothelial, and
head and neck cancer. There are two main types of T-cell transfer
therapy: tumor-infiltrating lymphocytes (or TIL)
therapy and
chimeric antigen receptor-modified T (CAR-T) cell therapy, mainly applied for
B-cell lymphoma and
leukemia and
mantle-cell lymphoma. HER2-targeted
therapies, mainly
trastuzumab, are associated with
left ventricular dysfunction, usually reversible and rarely life-threatening. PD/PDL-1 inhibitors can cause
myocarditis, rare but potentially fulminant and associated with a high fatality rate. CAR-T
therapy is associated with several cardiac toxic effects, mainly in the context of a systemic adverse effect, the
cytokines release syndrome.