Successful use of equine anti-thymocyte globulin (ATGAM) for fulminant myocarditis secondary to nivolumab therapy
- Resource Type
- Authors
- Maggie Moore; Elizabeth Blackley; Catriona McLean; Peter Bergin; Andrew Haydon; Rebecca Y. Tay; Sanjeev Gill
- Source
- British journal of cancer. 117(7)
- Subject
- Cancer Research
medicine.medical_specialty
Myocarditis
Fulminant
Ipilimumab
030204 cardiovascular system & hematology
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Temozolomide
Animals
Humans
Horses
Adverse effect
Antilymphocyte Serum
business.industry
Brain Neoplasms
Antibodies, Monoclonal
Chemoradiotherapy
Middle Aged
medicine.disease
Infliximab
Anti-thymocyte globulin
Dacarbazine
Nivolumab
Oncology
030220 oncology & carcinogenesis
Immunology
Female
business
Glioblastoma
medicine.drug
- Language
- ISSN
- 1532-1827
Immune-mediated myocarditis is an uncommon adverse effect of immune checkpoint inhibition and is associated with a high rate of mortality. In this reported case, a 64-year-old woman with right temporo-parietal glioblastoma IDH-WT was treated with nivolumab, temozolomide and radiation therapy on a clinical trial. She developed malignant arrhythmias secondary to histologically confirmed severe immune-mediated myocarditis. She was treated with equine anti-thymocyte globulin (ATGAM) due to development of malignant arrhythmias refractory to high-dose corticosteroids. This report describes the only case of immune-mediated myocarditis treated with ATGAM resulting in a favourable outcome. Use of ATGAM should be considered in cases of steroid-refractory immune-mediated myocarditis and administered in close consultation with a cardiac transplant team experienced in the use of this agent.