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Case Report



Dilated Cardiomyopathy from Immune Checkpoint Inhibitor, Nivolumab

Timothy Patrick McCann, Hatem Elabd, Stephen P Beerman.




Abstract
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Introduction: Nivolumab is an immune checkpoint inhibitor (ICI) in a class of immunomodulators used to treat various cancers, including melanoma. Here we present ICI-related cardiomyopathy leading to patient death.
Case Report: An 88-year-old female receiving therapy for metastatic melanoma with immune checkpoint inhibitor Nivolumab presented with acute hypoxic respiratory failure secondary to new onset acute combined systolic and diastolic heart failure. She had no known cardiac history and was on minimal medication before the presentation. After extensive workup, including pleural fluid analysis, a cardiac magnetic resonance, and left heart catheterization, no other cause could be attributed to her cardiac dysfunction other than an adverse medication event due to immunomodulation therapy with Nivolumab.
Discussion: Cardiomyopathy is a rare but potentially life-threatening complication of ICI therapy and should be considered when discussing treatment modalities with patients, especially in high-risk populations.

Key words: Nivolumab, immune checkpoint inhibitor, cardiomyopathy, melanoma






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