Radiation-induced coronary artery disease during immune checkpoint inhibitor therapy: a case report.
Xiajing QianKequan DingYi LuPublished in: Immunotherapy (2024)
Radiation-induced coronary artery disease (RICAD) poses a serious concern for cancer patients post radiotherapy, typically emerging after over a decade. Immune checkpoint inhibitors (ICIs), known for cardiotoxicity, are increasingly recognized for causing cardiovascular complications. Here we report the case of a 63-year-old man with metastatic lung cancer who developed coronary artery disease during his third-line therapy with an ICI (nivolumab) and an antiangiogenic agent (bevacizumab), 3 years post chest radiotherapy. Angiography revealed relatively isolated stenosis in the left main coronary artery ostium, consistent with the radiotherapy site, with no other risk factors, suggesting RICAD. The potential for ICIs to accelerate RICAD development should be considered and necessitates careful surveillance in patients receiving both radiotherapy and ICIs.
Keyphrases
- radiation induced
- coronary artery disease
- radiation therapy
- risk factors
- coronary artery
- percutaneous coronary intervention
- cardiovascular events
- coronary artery bypass grafting
- early stage
- locally advanced
- public health
- computed tomography
- pulmonary artery
- optical coherence tomography
- type diabetes
- risk assessment
- atrial fibrillation
- bone marrow