Scholarlink

Background and aims <p>With the increasing approval of immune checkpoint inhibitors (ICI) for cancer treatment, there is a rising incidence of potentially life-threatening cancer-therapy related cardiac dysfunction (CTRCD). Current 2022 European Society of Cardiology (ESC) guidelines on cardio-oncology recommend a single baseline transthoracic echocardiogram (TTE) for high-risk ICI-treated patients, potentially underestimating the incidence of CTRCD due to lack of follow-up assessments. This study aims to characterize the incidence of CTRCD in cancer patients undergoing ICI therapy using an intensified TTE surveillance approach and to investigate whether extracardiac immune-related adverse events (eirAEs) are associated with CTRCD.</p> Methods <p>We analysed patients scheduled for ICI therapy from the Essen Cardio-Oncology Registry (EcoR). Data were collected during cardio-oncology consultations at baseline, 6 weeks, 6 months, and 12 months. Patients with eirAEs were evaluated compared to patients without eirAEs.</p> Results <p>Among 2,540 cancer patients registered in EcoR until march 2023, 266 (61 ± 14 years, 40.6% female, 86.5% melanoma, 62% metastatic disease) were scheduled for ICI therapy. CTRCD was observed in 35.7% of patients, with 32.7% having asymptomatic mild CTRCD, 0.37% moderate CTRCD, and 2.63% developing heart failure with preserved ejection fraction (HFpEF). Patients with eirAEs had a twofold higher risk of CTRCD (relative risk [RR] 2.05, 95% CI: 1.49–2.83, <i>p</i> &lt; 0.001) and a 66% increased risk of cardiovascular toxicity (RR 1.66, 95% CI 1.30–2.13, <i>p</i> &lt; 0.001).</p> Conclusions <p>ICI therapy is associated with a high prevalence of CTRCD, underscoring the importance of serial echocardiography evaluation, particularly for patients with eirAEs.</p> <p>Enhanced cardio-oncology surveillance is crucial for improving patient outcomes and survival.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Cardiac dysfunction during immune checkpoint inhibitor therapy: association with extracardiac immune-related adverse events

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月16日

查看全文
  • Raluca I. Mincu,
  • Lena Lampe,
  • Lars Michel,
  • Amir A. Mahabadi,
  • Adelina V. Mark,
  • Lisa Zimmer,
  • Elisabeth Livingstone,
  • Dirk Schadendorf,
  • Alpaslan Tasdogan,
  • Tienush Rassaf,
  • Matthias Totzeck

摘要

Background and aims

With the increasing approval of immune checkpoint inhibitors (ICI) for cancer treatment, there is a rising incidence of potentially life-threatening cancer-therapy related cardiac dysfunction (CTRCD). Current 2022 European Society of Cardiology (ESC) guidelines on cardio-oncology recommend a single baseline transthoracic echocardiogram (TTE) for high-risk ICI-treated patients, potentially underestimating the incidence of CTRCD due to lack of follow-up assessments. This study aims to characterize the incidence of CTRCD in cancer patients undergoing ICI therapy using an intensified TTE surveillance approach and to investigate whether extracardiac immune-related adverse events (eirAEs) are associated with CTRCD.

Methods

We analysed patients scheduled for ICI therapy from the Essen Cardio-Oncology Registry (EcoR). Data were collected during cardio-oncology consultations at baseline, 6 weeks, 6 months, and 12 months. Patients with eirAEs were evaluated compared to patients without eirAEs.

Results

Among 2,540 cancer patients registered in EcoR until march 2023, 266 (61 ± 14 years, 40.6% female, 86.5% melanoma, 62% metastatic disease) were scheduled for ICI therapy. CTRCD was observed in 35.7% of patients, with 32.7% having asymptomatic mild CTRCD, 0.37% moderate CTRCD, and 2.63% developing heart failure with preserved ejection fraction (HFpEF). Patients with eirAEs had a twofold higher risk of CTRCD (relative risk [RR] 2.05, 95% CI: 1.49–2.83, p < 0.001) and a 66% increased risk of cardiovascular toxicity (RR 1.66, 95% CI 1.30–2.13, p < 0.001).

Conclusions

ICI therapy is associated with a high prevalence of CTRCD, underscoring the importance of serial echocardiography evaluation, particularly for patients with eirAEs.

Enhanced cardio-oncology surveillance is crucial for improving patient outcomes and survival.