JMA Journal

Figure 1. Effects of immune checkpoint inhibitors on tumor cells and cardiomyocytes.
Inhibition of suppressive factors called “immune checkpoints” accelerates activated T-cell to invade and injure tumor cells but may also allow the immune system to attack normal organs in our body, including the heart.
APC, antigen-presenting cell; CTLA-4, cytotoxic T-lymphocyte antigen 4; MHC, major histocompatibility complex; PD-1, program death ligand 1; PD-L1/PD-L2, programmed cell death ligand 1 or ligand 2; TCR, T-cell receptor; TNF-α, tumor necrosis factor-α; IFN-γ, interferon-γ.

Figure 2. Immune-related adverse events in each organ.

Figure 3. Flow diagram for optimal cardiovascular follow-up of patients treated with ICIs.
BNP, B-type natriuretic peptide; CK, creatinine kinase; CK-MB, creatine kinase myocardial band; CMR, cardiac magnetic resonance; ECG, electrocardiogram; NT-proBNP, N-terminal pro BNP; ICIs, immune checkpoint inhibitors.