A Prospective Study to Detect Immune Checkpoint Inhibitors Associated With Myocarditis Among Patients Treated for Lung Cancer.

Autor:	Faubry C; Pulmonary Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France., Faure M; Heart Failure Unit, Cardiology Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France., Toublanc AC; Pulmonary Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France., Veillon R; Pulmonary Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France., Lemaître AI; Heart Failure Unit, Cardiology Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France., Vergnenègre C; Pulmonary Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France., Cochet H; Department Cardiology, Lyric Institute, Fondation Bordeaux Université, Bordeaux, France.; Department Medicine, Universitaire Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France.; Department of Cardiovascular Imaging, Centre Hospitalier Universitaire (CHU) Bordeaux, Bordeaux, France., Khan S; Bordeaux University, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, Bordeaux, France., Raherison C; Pulmonary Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France.; Bordeaux University, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, Bordeaux, France., Dos Santos P; Heart Failure Unit, Cardiology Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France.; Department Cardiology, Lyric Institute, Fondation Bordeaux Université, Bordeaux, France.; Department Medicine, Universitaire Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France., Zysman M; Pulmonary Department, Centre Hospitalier Universitaire (CHU) Haut-Lévèque, Bordeaux, France.; Centre de Recherche Cardio-Thoracique, Universitaire Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2022 Jun 06; Vol. 9, pp. 878211. Date of Electronic Publication: 2022 Jun 06 (Print Publication: 2022).
DOI:	10.3389/fcvm.2022.878211
Abstrakt:	Background: Immune checkpoint inhibitors (ICIs) are widely used in lung cancer management. However, myocarditis, which is a rare, yet potentially severe adverse-related event associated with ICIs, could be under-reported. Objectives: This study is aimed to prospectively evaluate the cumulative incidence rate of myocarditis, through systematic screening, among patients receiving ICIs for lung cancer. Methods: All patients who received the first administration of ICIs for non-small cell (NSCLC) and small cell lung cancer (SCLC), between May and November 2020, in the pulmonary department of Bordeaux University Hospital, were included. Echocardiography (ECG), troponin-I, and natriuretic peptide dosages before ICIs' first administration and before each infusion were recorded. ECG and magnetic resonance imaging (MRI) were done additionally, in case of at least three times increase in troponin levels, ECG modifications, and the onset of cardiovascular symptoms. Second, if possible, coronarography than endomyocardial biopsy was assessed. The primary outcome was defined as ICIs related to myocarditis onset, while secondary outcomes included other cardiovascular events, disease-free, and overall survival. Results: During the period of interest, 99 patients received their first infusion of ICIs for lung cancer (mean age 64 ± 9 years; 52 men, 67% with adenocarcinoma). Three cases of myocarditis without major adverse cardiac events (MACEs) occurred (two definite and one possible), and the mean duration between the first ICIs' administration and myocarditis onset was 144 ± 3 days. Median disease-free survival and overall survival were 169 [102; 233] days and 209 [147; 249] days, respectively. Conclusion: In our study, systematic screening of myocarditis associated with ICIs leads to a more frequent incidence and a later onset than previously reported. None of them were severe. Additional prospective evidence is needed before we could adopt routine cardiac screening in unselected patients starting ICIs; however, these data shed new light on the risk of myocarditis associated with ICIs administration. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Faubry, Faure, Toublanc, Veillon, Lemaître, Vergnenègre, Cochet, Khan, Raherison, Dos Santos and Zysman.)
Databáze:	MEDLINE
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