Increased risk for cardiovascular events associated with immune checkpoint inhibitor therapy

September 2022 Science Nalinee Pathak

Researchers from Belgium report that patients undergoing immune checkpoint inhibitor therapy (ICI) have an increased risk of cardiovascular events, particularly in those with a prior history of cardiovascular disease. The findings of this study were recently published in the Journal of Clinical Oncology.

Rare events of cardiovascular events due to ICI therapy are known. However, major adverse cardiovascular events (MACE) during or after treatment with ICI remain unknown. The researchers have addressed this issue by performing a retrospective analysis of the existing clinical trials.

Retrospective analysis

The analysis included data from 672 patients (median age 65 years, 64.7% men) with cancer treated with ICIs and a median follow-up of 13 months. The rates of cardiovascular events were compared with untreated cancer patients and population controls (matched to age, sex, cardiovascular history and cancer type). The study’s primary endpoints included MACE, and secondary endpoints were acute coronary syndrome and heart failure separately.

Main findings

The data analysis found that the incidence of MACE was 10.3% during the follow-up period of 13 months (range 6-22 months). Results of the multivariable analysis revealed that the history of heart failure (hazard ratio 2.27; 95% CI, 1.03 to 5.04; P = .043) and valvular heart disease (hazard ratio 3.01; 95% CI, 1.05 to 8.66; P = .041) were significantly associated with MACE. Also, the cumulative incidence rates were higher in cancer patients receiving ICI treatment than those without immune checkpoint treatments. 

Conclusion

The findings underscore the need for screening for cardiovascular workup of patients before treating them with ICI, especially those with a history of cardiovascular diseases.

Reference

Laenens D, Yu Y, Santens B, Jacobs J, et al. Incidence of Cardiovascular Events in Patients Treated With Immune Checkpoint Inhibitors. J Clin Oncol. 2022 Jun 30:JCO2101808.

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