Evidence map›Paper›PMID 40598522›Full record

SynthesisJournal of translational medicine2025

Cardiotoxicity in cancer immunotherapy: a systematic review and global meta-analysis.

Fanlin Zhou, Guangyue Liu, Shunhong Zhang, Chenchen Luo, Saidi Hu, Siran Wan, Weixi Xiong, Linyong Zhao

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Cardiotoxicity in breast cancer patients treated with chemoradiotherapy.Exploration of targeted anti-tumor therapy · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Fanlin ZhouWest China School of Medicine, Sichuan University, Chengdu, China.
Guangyue LiuDepartment of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Shunhong ZhangDepartment of Cardiology, Panzhihua Iron and Steel Group General Hospital, Panzhihua, China.
Chenchen LuoDepartment of Outpatient Chengbei, the Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China.
Saidi HuDepartment of Stomatology, Yaan people's Hospital, Yaan, China.
Siran WanDepartment of Gynaecology and Obstetrics, Yaan people's Hospital, Yaan, China.
Weixi XiongDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Linyong ZhaoDepartment of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy / Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China. 153795352@scu.edu.cn.ORCID 0000-0003-0884-4657

Funding

Sichuan Science and Technology Program No.2025ZNSFSC0715；No.2018SZ0147
6 · The paper itself

Abstract

objectiveCancer immunotherapy enhances the prognosis of cancer patients; however, it has been shown to be associated with potentially fatal cardiac risks, which requires further confirmation. This study aimed to explore the cardiotoxicity of immune checkpoint inhibitors (ICIs) in solid tumors.

methodsA systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the PROSPERO database, CRD42024614721. All randomized controlled trials (RCTs) comparing ICI with placebo and reporting complete adverse events in solid tumors were included. The primary outcome is the relative risk (RR) of cardiotoxicity for the purpose of discerning the disparities between the two groups. Data were pooled using random-effects model.

resultsA total of 101 RCTs involving 58,698 patients were included. The incidence of all-grade cardiotoxicity was 3.0% in the ICI group and 2.3% in the placebo group. The pooled relative risk for cardiotoxicity was higher with ICI compared with placebo (RR = 1.31, 95% CI = 1.17-1.48, P<0.001). Regarding individual cardiac adverse event, the pooled relative risks for myocarditis (RR = 1.79, 95%CI = 1.11-2.91, p = 0.018) and arrhythmia (RR = 1.22, 95%CI = 1.04-1.44, p = 0.016) were also higher with ICI compared with placebo. Sensitivity analysis demonstrated consistency in the overall estimate.

conclusionsOur study illustrated an increased cardiotoxicity of the use of ICI as single or combination regimens including myocarditis and arrhythmia based on a large number of the latest RCTs. More cautious attention should be paid on the ICIs-induced cardiotoxicities during cancer immunotherapy, especially for myocarditis and arrhythmia.

Indexed as

CardiotoxicityImmunotherapyNeoplasmsHumansImmune Checkpoint InhibitorsPublication BiasRandomized Controlled Trials as TopicImmune Checkpoint InhibitorsCardiotoxicityImmune checkpoint inhibitorsImmunotherapySolid tumor

Identifiers

PMID40598522
PMCPMC12220369

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.