Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity
Abstract Aims Inflammatory biomarkers, including CRP, the neutrophil‐to‐lymphocyte ratio (NLR), and the neutrophil‐to‐eosinophil ratio (NER), may predict outcomes in cancer. However, their value in immune checkpoint inhibitor (ICI) therapy‐associated cardiotoxicity remains elusive. We aimed to chara...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-06-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14340 |
| _version_ | 1797824656607019008 |
|---|---|
| author | Lin Liang Chanjuan Cui Dan Lv Yiqun Li Liyan Huang Jiayu Feng Tao An Pengchao Tian Ke Yang Linjun Hu Lizhen Gao Jian Zhang Yuhui Zhang Fei Ma Yanfeng Wang |
| author_facet | Lin Liang Chanjuan Cui Dan Lv Yiqun Li Liyan Huang Jiayu Feng Tao An Pengchao Tian Ke Yang Linjun Hu Lizhen Gao Jian Zhang Yuhui Zhang Fei Ma Yanfeng Wang |
| author_sort | Lin Liang |
| collection | DOAJ |
| description | Abstract Aims Inflammatory biomarkers, including CRP, the neutrophil‐to‐lymphocyte ratio (NLR), and the neutrophil‐to‐eosinophil ratio (NER), may predict outcomes in cancer. However, their value in immune checkpoint inhibitor (ICI) therapy‐associated cardiotoxicity remains elusive. We aimed to characterize the relationship of inflammatory markers with severity of ICI‐related cardiotoxicities (iRCs) and prognosis among patients with iRCs. Methods Patients who were diagnosed with iRCs between January 2019 and December 2021 were retrospectively enrolled and were dichotomized based on iRC severity into low‐grade (grade 1–2) vs. high‐grade (grade 3–4) groups. Results Forty‐seven patients were included. The median time‐to‐event from first ICI infusion to onset of iRCs was 35 days (IQR: 19.0–65.5 days). When compared with respective baseline values, cardiac biomarkers and inflammatory markers were significantly elevated at onset of iRCs. Compared with low‐grade iRCs, NER at iRC onset was significantly increased among patients with high‐grade iRCs (Group × Time, P < 0.01). When grouped by the median NER (184.33) at iRC onset, NER ≥ 184.33 was associated with high‐grade iRCs (OR: 10.77, P < 0.05) and had a 36.3% increased mortality compared to the lower NER group (HR: 2.67, P < 0.05). Conclusions In patients who develop iRCs, NER is significantly elevated at iRC onset, and higher NER correlates with greater iRC severity and higher mortality. Larger datasets are needed to validate these findings. |
| first_indexed | 2024-03-13T10:42:19Z |
| format | Article |
| id | doaj.art-9f0342d3a09242a1bcc21f26e9d1a0a5 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-13T10:42:19Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-9f0342d3a09242a1bcc21f26e9d1a0a52023-05-18T03:08:57ZengWileyESC Heart Failure2055-58222023-06-011031907191810.1002/ehf2.14340Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicityLin Liang0Chanjuan Cui1Dan Lv2Yiqun Li3Liyan Huang4Jiayu Feng5Tao An6Pengchao Tian7Ke Yang8Linjun Hu9Lizhen Gao10Jian Zhang11Yuhui Zhang12Fei Ma13Yanfeng Wang14Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaHeart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaHeart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaHeart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaHeart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology Cancer Hospital of HuanXing Chaoyang District Beijing Beijing ChinaDepartment of Urology Cancer Hospital of Huanxing Chaoyang District Beijing Beijing ChinaDepartment of Medical Oncology Cancer Hospital of HuanXing Chaoyang District Beijing Beijing ChinaHeart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaHeart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaAbstract Aims Inflammatory biomarkers, including CRP, the neutrophil‐to‐lymphocyte ratio (NLR), and the neutrophil‐to‐eosinophil ratio (NER), may predict outcomes in cancer. However, their value in immune checkpoint inhibitor (ICI) therapy‐associated cardiotoxicity remains elusive. We aimed to characterize the relationship of inflammatory markers with severity of ICI‐related cardiotoxicities (iRCs) and prognosis among patients with iRCs. Methods Patients who were diagnosed with iRCs between January 2019 and December 2021 were retrospectively enrolled and were dichotomized based on iRC severity into low‐grade (grade 1–2) vs. high‐grade (grade 3–4) groups. Results Forty‐seven patients were included. The median time‐to‐event from first ICI infusion to onset of iRCs was 35 days (IQR: 19.0–65.5 days). When compared with respective baseline values, cardiac biomarkers and inflammatory markers were significantly elevated at onset of iRCs. Compared with low‐grade iRCs, NER at iRC onset was significantly increased among patients with high‐grade iRCs (Group × Time, P < 0.01). When grouped by the median NER (184.33) at iRC onset, NER ≥ 184.33 was associated with high‐grade iRCs (OR: 10.77, P < 0.05) and had a 36.3% increased mortality compared to the lower NER group (HR: 2.67, P < 0.05). Conclusions In patients who develop iRCs, NER is significantly elevated at iRC onset, and higher NER correlates with greater iRC severity and higher mortality. Larger datasets are needed to validate these findings.https://doi.org/10.1002/ehf2.14340ICI, immune checkpoint inhibitoriRC, immune checkpoint inhibitor‐related cardiotoxicityInflammatory biomarkersNER, neutrophil‐to‐eosinophil ratio |
| spellingShingle | Lin Liang Chanjuan Cui Dan Lv Yiqun Li Liyan Huang Jiayu Feng Tao An Pengchao Tian Ke Yang Linjun Hu Lizhen Gao Jian Zhang Yuhui Zhang Fei Ma Yanfeng Wang Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity ESC Heart Failure ICI, immune checkpoint inhibitor iRC, immune checkpoint inhibitor‐related cardiotoxicity Inflammatory biomarkers NER, neutrophil‐to‐eosinophil ratio |
| title | Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity |
| title_full | Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity |
| title_fullStr | Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity |
| title_full_unstemmed | Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity |
| title_short | Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity |
| title_sort | inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor associated cardiotoxicity |
| topic | ICI, immune checkpoint inhibitor iRC, immune checkpoint inhibitor‐related cardiotoxicity Inflammatory biomarkers NER, neutrophil‐to‐eosinophil ratio |
| url | https://doi.org/10.1002/ehf2.14340 |
| work_keys_str_mv | AT linliang inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT chanjuancui inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT danlv inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT yiqunli inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT liyanhuang inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT jiayufeng inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT taoan inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT pengchaotian inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT keyang inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT linjunhu inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT lizhengao inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT jianzhang inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT yuhuizhang inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT feima inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity AT yanfengwang inflammatorybiomarkersinassessingseverityandprognosisofimmunecheckpointinhibitorassociatedcardiotoxicity |