Clinical diagnosis and treatment recommendations for immune checkpoint inhibitor-associated myocarditis (2026 edition)

Abstract

Immune checkpoint inhibitors (ICIs) deliver prominent anti-tumor efficacy across multiple malignancies, yet ICI-associated myocarditis represents a life-threatening adverse event requiring standardized management. Updated from the 2022 version, these recommendations integrate up-to-date domestic and international real-world data and emerging evidence concerning bispecific antibody-related cardiac injury, thymic imaging grading, artificial intelligence-assisted early screening, and optimized second-line immunosuppressive regimens. These recommendations provide standardized practical guidance for prevention, early recognition and individualized intervention to improve patient outcomes.

Keywords

Immune checkpoint inhibitor / Immune checkpoint inhibitor-associated myocarditis / Immune-related adverse event / Cardio-oncology

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Funding

National Natural Science Foundation of China(82470354)

National Natural Science Foundation of China(82170359)

National Natural Science Foundation of China(82400419)

National Natural Science Foundation of China(82400530)

Major National Science and Technology Projects on Four Major Chronic Diseases(2023ZD0502800)

National Major Science and Technology Projects​ (2025YFC2425400)

Shanghai Shenkang Hospital Development Center municipal hospital diagnosis and treatment technology project(SHDC12026121)

Shanghai Shenkang Hospital Development Center municipal hospital diagnosis and treatment technology project (SHDC22023207)

Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2023-JKCS-28)

RIGHTS & PERMISSIONS

The Author(s)