A serum proteomics-based predictive model for steroid-resistant immune checkpoint inhibitor associated myocarditis

Background

Immune checkpoint inhibitor-associated myocarditis (ICIAM) is one of the immune-related adverse events (irAEs) with low incidence but extremely high mortality. High-dose glucocorticoid pulse therapy remains the recommended initial treatment for patients with ICIAM. However, an inadequate response to corticosteroid therapy is observed in some patients, who are subsequently classified as having steroid-resistant immune checkpoint inhibitor-associated myocarditis (srICIAM). Early combination of second-line immunosuppression may represent an effective therapeutic strategy. However, Biomarkers capable of identifying such patients before treatment are currently lacking. We therefore sought to characterize circulating inflammatory proteins associated with corticosteroid responsiveness and to derive a preliminary serum-based prediction model for steroid-resistant ICIAM (srICIAM).