Studies have shown that cancer patients taking immunotherapy drugs have a higher risk of heart problems.

Studies have shown that cancer patients taking immunotherapy drugs have a higher risk of heart problems.

Washington: A study of more than a thousand cancer patients treated with immunotherapy with drugs found that these patients were at higher risk of heart problems, including death from a heart attack or stroke. Including
Patients had either lung cancer or malignant melanoma (a type of skin cancer), for which immune checkpoint inhibitors such as programmed cell death 1 (PD1) inhibitors or cytotoxic T lymphocyte-associated protein 4 (CTLA-4) Inhibitors are used. The study, published today (Wednesday) in the European Heart Journal [1]It was found that the risk of heart trouble in patients was higher than previous safety statistics for these drugs.
The study was led by Dr. Maria de Souza, a medical doctor and postdoctoral research fellow at the Department of Cardiology at Hellero and Gentoft Hospital, Hellerp, Denmark. He and his colleagues found that one year after starting treatment with immune checkpoint inhibitors, about 10% of lung cancer patients3 patients (either pembrolizumab or nivolumab) had heart failure, on PD1 inhibitors. From uncontrolled heartbeats, to heart problems. ), Inflammation of the heart (myocarditis or pericarditis) or heart-related death, such as a heart attack.
Of the 13,568 patients with malignant melanoma, 145 were treated with PD1 inhibitors and 212 were treated with the CTLA-4 inhibitor ipilimumab. One year after starting treatment, 6.6% and 7.5% had heart problems, respectively.
The researchers found that patients who were not treated in this way had a higher risk of heart disease than those who stopped the immune checkpoint. Within six months of starting treatment, lung cancer patients with PD1 inhibitors had twice the risk of heart problems. Patients with malignant melanoma have a 4.3-fold increased risk if they are dealing with PD1 inhibitors and a five-fold increased risk if they are receiving a CTLA-4 inhibitor.
After six months, the risk of heart problems for lung cancer patients with a 2.3-fold risk for PD1 inhibitors increased slightly. However, this risk was not statistically significant for melanoma patients on PD1, and slightly lower than the 3.5-fold risk for those receiving CTLA4 inhibitors.
The study analyzed nationwide data from 25,573 people from Danish national registries when they were diagnosed with lung cancer or malignant melanoma in 2011, when immunosuppressive treatment Was introduced, and 2017.
Dr de Souza said: “We believe that based on the nationwide data on hospital admissions and drug administration, patients with this lung and melanoma patients with immune blockage should be treated for heart problems. To investigate the risk, this is the first study of its size. One year of heart problems in patients with lung cancer with PD1 inhibitors and in patients with malignant melanoma with either PD1 or CTLA-4 inhibitors. Able to confirm the absolute risks of. Studies, which have suggested that approximately 0.0 0.03-1% of people with immunodeficiency syndrome develop myocarditis or pericarditis within a year from our results. Appears that 1.8 will will.
“We also found that people who were treated with immunosuppressive immunosuppressants were at higher risk of heart disease than those who were not receiving immunosuppressants. Previous studies have shown this to be the case.” Most of the negative side effects that affect the heart are found soon after treatment, starting in the first few weeks or months. However, our results show an increase in heart problems after the first six months. The threat continues.
“We hope this information can be helpful in informing doctors that additional attention needs to be paid to patients who are blocking the immune system.”
“Although these drugs will be rigorously tested in randomized controlled clinical trials before being approved for clinical use, they can still affect organs, causing both general and extremely rare side effects. “Large-scale epidemics like ours can be helpful in our study. With more accurate estimates of how often these side effects occur when these drugs are used for clinical treatment.”
Researchers say they need to learn more about the side effects of immunosuppressive therapy, and have launched an observational clinical study of patients receiving these drugs to monitor heart function. ۔ They hope this will help them understand and predict which patients will have serious or sometimes fatal side effects.
Since this was an observational study, based on registry data, treatment with immune checkpoints was not randomized. The researchers calculated the factors that could affect their results, such as age, sex and the time of the cancer. However, they did not have information on whether patients smoked, the stage of the cancer and other medical factors that could affect the results. Another limitation was that the study was unable to reliably analyze blood vessel problems, such as stroke, as they may take longer than the average follow-up time (164-326 days) in the study. Nor was it possible to see the association between heart problems and the different intensities of treatment and the different combinations of treatments.
Together in the editorial [2]Dr. Thomas Nylon, director of the Cardio Oncology Program at Massachusetts General Hospital (Boston, USA), and co-author writes: “Perhaps it is time for a broader explanation of ICI. [immune checkpoint inhibitors]The inclusion and inclusion of the term ‘ICI-related heart disease’ encourages and supports cardiovascular complications with critical insights provided by D’Souza and colleagues. Immediate steps include raising our awareness of the wide range of possible cardiac toxicities associated with ICI treatment.
“Long-term initiatives include expanding collaborations with our oncology and pharmaceutical partners, and expanding clinical research efforts based on parallel and modern basic experimental insights. These and other initiatives are needed to move forward.” So that we can improve the cardiovascular outcomes in our cancer patients. Treat ICI. ”

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