Similar to the HFA-ICOS risk stratification tool for patients on chemotherapy, are there cardiac risk calculators available for use in patients starting immunotherapy? 

No, there are no cardiac risk calculators for patients starting on immune checkpoint inhibitors (ICI). This is primarily because, aside from the use of dual immune checkpoint inhibitor therapy, we have not identified risk factors for ICI-induced myocarditis (Mahmood et al., PMID 29567210). Prior to starting on ICI, it is recommended to check an ECG and troponin to establish a baseline since abnormalities in ECG findings/troponin can be an indication of cardiotoxicity on ICI (Lehmann et al., PMID 34232253).

There is data that ICI therapy may accelerate arterial atherosclerosis (Suero-Abreu et al., PMID 36636438) so in my practice, I check a baseline lipid panel to guide optimization of CV preventative therapies.

Currently, there are no validated risk calculators available for predicting ICI-induced cardiovascular immune-related adverse events (irAEs). Several risk factors have been reported to be associated with a higher risk of experiencing cardiac irAEs. These risk factors include a history of preexisting cardiac conditions, older age, longer duration of therapy, and certain types of cancer. Patients with preexisting autoimmune diseases are thought to be at increased risk given the baseline dysregulation of the immune system. Additionally, the use of combination therapy (ICI + ICI or ICI + chemotherapy) has been reported to be an important risk factor for developing irAEs. Combination therapy is associated with up to a twofold increased risk in s...

No, not currently.