Prospective cardiovascular events in patients with advanced thoracic cancer treated with immune checkpoint inhibitor.

Autor: Toublanc AC; Pulmonary Department, CIC1401, CHU Haut-Lévèque, Bordeaux, France. Electronic address: anne-claire.toublanc@chu-bordeaux.fr., Faure M; Heart failure unit, Cardiology Department, CHU Haut-Lévèque, Bordeaux, France., Verdy G; Medical Informatics and Archiving Unit, CHU Bordeaux, France., Rabeau A; Pulmonary Department, CHU Larrey, Toulouse, France., Houard V; Arterial hypertension unit, Cardiology Department, CHU Rangueil, Toulouse, France., Veillon R; Pulmonary Department, CIC1401, CHU Haut-Lévèque, Bordeaux, France., Bardel C; Pulmonary Department, CIC1401, CHU Haut-Lévèque, Bordeaux, France., Vergnenegre C; Pulmonary Department, CIC1401, CHU Haut-Lévèque, Bordeaux, France., Dos Santos P; Heart failure unit, Cardiology Department, CHU Haut-Lévèque, Bordeaux, France; Lyric Institute, Bordeaux University, Pessac, France; University Institute of cancer, INSERM UMR1037, Toulouse, France., Mazieres J; Pulmonary Department, CHU Larrey, Toulouse, France; Oncology Research Center CRCT, INSERM UMR1037, Toulouse, France., Zysman M; Pulmonary Department, CIC1401, CHU Haut-Lévèque, Bordeaux, France; Bordeaux University, INSERM U1045, Pessac, France.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2024 Aug; Vol. 207, pp. 114191. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1016/j.ejca.2024.114191
Abstrakt: Introduction: Myocarditis is the most lethal cardiovascular immune related adverse events with a low incidence, depending on the studies. We prospectively studied the potential interest of a systematic screening to early detect immune related myocarditis and confirm the incidence of immune-induced myocarditis in advanced lung cancer and the impact of troponin systematic screening in early detection of other major cardiovascular events (MACE).
Material and Methods: This prospective bicentric study includes adults who received at least one dose of immune checkpoint inhibitor (ICI) for advanced lung cancer. Cardiac biomarkers dosage, ECG and transthoracic echography (TTE) were done at baseline. Diagnosis of myocarditis was based on European Society of Cardiology recommendations. MACEs were reported during the observation period.
Results: Among 298 patients, 5 (1.68 %) immune-induced myocarditis occurred, all being asymptomatic with at first troponin elevation, treated by corticosteroids and ICI's discontinuation. No attributable death occurred, and no specific clinical characteristics were identified with myocarditis onset. Three patients were rechallenged with ICI after troponin normalization in the absence of other therapeutic options. Recurrence occurred in 2 patients, with a re-increase of troponin and a de novo modification of the ECG. Systematic cardiovascular screening also led to 14 cardiovascular diseases detection and 11 MACEs during ICI.
Conclusion: Systematic cardiovascular screening has uncovered slightly more immuno-induced myocarditis cases than reported previously, but without altering treatment strategies due to their subclinical nature. Additionally, it helps detecting other cardiovascular diseases in this comorbid population.
Competing Interests: Declaration of Competing Interest ACT, MF, GV, AR, VH, RV, CB, CV, PDS, JM and MZ have no conflicts of interest to disclosure.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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