Immune Checkpoint Inhibitor Therapy Induces Inflammatory Activity in the Large Arteries of Lymphoma Patients under 50 Years of Age

Author(s)
Raffaella Calabretta, Philipp B. Staber, Christoph Kornauth, Xia Lu, Patrick Binder, Verena Pichler, Markus Mitterhauser, Alexander Haug, Xiang Li, Marcus Hacker
Abstract

Background: Immune checkpoint inhibitors (ICI) have transformed the management of various cancers. Serious and potentially fatal cardiovascular toxicity, as well as a progression of atherosclerosis, have been described, mainly in elderly and comorbid patients. Methods: We investigated 117 arterial segments of 12 young (under 50 years of age), otherwise healthy lymphoma patients pre/post-ICI treatment using 2-[18F]fluorodeoxyglucose (FDG) positron emission tomography (PET). Maximum FDG standardized uptake values (SUVmax) and target-to-background ratios (TBRs) were calculated along arterial segments. Additionally, metabolic activities (SUVmax) of the bone marrow, spleen, and liver were analyzed. The levels of high-sensitivity C-reactive protein (hsCRP) were assessed. Results: ICI therapy induced arterial inflammatory activity, detected by increased TBR in arterial segments without pre-existing inflammation (TBRneg_pre = 1.20 ± 0.22 vs. TBRneg_post = 1.71 ± 0.45, p < 0.001), whereas already-inflamed lesions remained unchanged. Dormant calcified segments (Hounsfield Units-HU ≥ 130) showed a significant increase in TBR values after ICI treatment (TBRcalc_pre = 1.36 ± 0.38 vs. TBRcalc_post = 1.76 ± 0.42, p < 0.001). FDG uptake measured in other organs and hsCRP levels remained unchanged after ICI therapy. Conclusions: Although the effects of ICI therapy on arterial inflammation are still incompletely understood, cancer immunotherapy might be a critical moderator of atherosclerosis with a subsequently increased risk of future cerebro- and/or cardiovascular events in young oncological patients.

Organisation(s)
External organisation(s)
Medizinische Universität Wien
Journal
Biology
Volume
10
No. of pages
6
ISSN
2079-7737
DOI
https://doi.org/10.3390/biology10111206
Publication date
11-2021
Peer reviewed
Yes
Austrian Fields of Science 2012
302054 Nuclear medicine
Keywords
ASJC Scopus subject areas
General Agricultural and Biological Sciences, General Biochemistry,Genetics and Molecular Biology, General Immunology and Microbiology
Portal url
https://ucrisportal.univie.ac.at/en/publications/60baedaa-3b02-4c31-82b6-f26d452c59f0