Han Zhu, MD, Stanford University, Standford, CA, discusses immune-mediated mechanisms in checkpoint inhibitor-induced myocarditis and investigating druggable targets as well as biomarkers to predict the development of autoimmunity. TAMRA CD8 T-cells of patients who had developed myocarditis were found to express high levels of certain chemokines, including CCL5 and CCL4, that are suspected to play a role in helping recruit other immune cells to the area of inflammation, the heart. Inhibition of these pathways are now being investigated using murine models to see whether myocarditis can be attenuated. In regard to diagnosing immune checkpoint inhibitor myocarditis, there is no single modality that is completely effective, for instance cardiac MRI is not 100% sensitive and sample bias can occur during cardiac biopsy, which is a highly invasive technique. A clinical program is currently underway, exploring troponin as a biomarker to monitor and screen patients who are receiving immunotherapy. This interview took place at the 37th Annual Meeting of the Society for Immunotherapy in Cancer (SITC 2022) in Boston, MA.
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