Treatment of immune checkpoint inhibitor related myocarditis

Aims: The specific aims of the pilot study is to provide data to prepare for a future national, open-label proof of concept clinical treatment study assessing the safety and efficacy  interleukin 6 inhibition (IL6i) for the treatment of immune checkpoint inhibitor (ICI) related myocarditis (ICIrM).

Background:  ICIrM is a rare complication to ICI cancer therapy but  the increasing number of patients in combination with a reported mortality of 30-40% summons up to a significant clinical problem. Current treatment guidelines with high dose cortisone are based on retrospectiv data.

IL6 is used for  other irAEs, and we suggest a national open -label proof of concept clinical treatment study to asses early IL6i in the treatment of ICIrM.

Methods: We will perform a systematic review covering clinical data on IL6 blockade for ICIrM treatments  according to the PRISMA framework (2024) and a retrospective single center study of diagnosis, management and cardiovascular och cancer outcome i patients with ICIrM at Karolinska University Hospital (2024).

These subprojects will be the base for planning and preparing the future treatment study, The project organisation and steering committe is a multidisciplinary team to secure all aspects of optimal dimensioning, patient eligbility, outcome measures.

This group will also be the steering committe for the national ICIrM network to provide a base for future treatment study.