Risk elements and diagnostic indicators for asymptomatic immune checkpoint inhibitor-associated myocarditis in esophageal cancer

Abstract

This article pertains to the study by Liu et al. Myocarditis caused by immune checkpoint inhibitors in patients with esophageal cancer is a concerning issue. This was found to be linked by increased levels of creatine kinase (CK) and CK isoenzymes, as well as older age and male gender. All these risk factors behind this phenomenon, which could be incorporated into a unified prediction model, have been briefly discussed. Several recommendations have been made to validate this prediction model for use in different clinical scenarios.

Keywords: Myocarditis; Immune checkpoint inhibitors; Esophageal cancer; Immunotherapy; Risk factor

Core Tip: Immune checkpoint inhibitors, which play a significant role in esophageal cancer therapy, can cause myocarditis in these patients. Several risk factors, such as advanced age, male sex, elevated creatine kinase (CK) and CK isoenzymes, contribute to this phenomenon. All these indicators can be combined into a single model to aid in early detection and personalized risk management. Prospective cohort studies with large sample sizes should be conducted, utilizing modern imaging modalities like magnetic resonance imaging.