TNF and heart failure: Although TNF-α is increased in the serum, macrophages and myocardial cells of patients with heart failure syndrome,25 cardiac toxicity has been well reported with infliximab, and it has been shown to adversely affect the clinical condition of patients with moderate to severe heart failure.26 27 In addition, cases of myocarditis have also been described under this treatment.28 These data, combined with those from our study, suggest that infliximab should not be used as first-line therapy after corticosteroids in patients with ICI-induced myocarditis.