Arterial inflammation on [18F]FDG PET/CT in melanoma patients treated with and without immune checkpoint inhibitors: CHECK-FLAME I

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Atherosclerosis Pub Date : 2024-09-07 DOI:10.1016/j.atherosclerosis.2024.118595

Elissa A.S. Polomski , Ellen W. Kapiteijn , Julius C. Heemelaar , Anne V. van der Kolk , Timo M. Kalisvaart , Alina van de Burgt , Petra Dibbets-Schneider , Floris H.P. van Velden , Tom T.P. Seijkens , J. Lauran Stöger , J. Wouter Jukema , Lioe-Fee de Geus-Oei , M. Louisa Antoni

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Abstract

Background and aims

Immune checkpoint inhibitors (ICIs) revolutionized cancer treatment. However, ICIs may increase the immune response to non-tumor cells, possibly resulting in increased arterial inflammation, raising the risk of atherosclerotic events. Nevertheless, malignancies may induce a pro-inflammatory state and the association between ICIs and arterial inflammation remains to be clarified. This study aims to assess differences in increase in arterial inflammation between patients with advanced melanoma treated with ICIs compared to a control group without ICIs.

Methods

Patients with advanced melanoma who underwent [¹⁸F]FDG PET/CT scans at baseline, 6 months (T1) and 18 months (T2) were included in this retrospective observational study. Arterial inflammation was evaluated in eight segments by calculating the target-to-background ratio (TBR). The primary study outcome was the difference in increase in mean TBR_max between patients treated with and without ICIs.

Results

We included 132 patients of whom 72.7 % were treated with ICIs. After exclusion for the use of anti-inflammatory medication, patients treated with ICIs showed a significant increase in mean TBR_max between baseline and T1 from 1.29 ± 0.12 to 1.33 ± 0.13 (p = 0.017), while in the control group, no change in mean TBR_max (1.30 ± 0.12 to 1.28 ± 0.10, p = 0.22) was observed (p = 0.027). During longer follow-up, mean TBR_max remained stable in both groups. Arterial inflammation increased significantly after ICI therapy in patients without active inflammation (p < 0.001) and in patients without calcifications (p = 0.013).

Conclusions

A significant increase in arterial inflammation as measured on [¹⁸F]FDG PET/CT was observed in patients with advanced melanoma treated with ICIs only in the first six months after initiation of therapy, whereas no changes were observed in the control group. Moreover, arterial inflammation was mainly increased in patients without pre-existing inflammatory activity and with non-calcified lesions.

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接受和未接受免疫检查点抑制剂治疗的黑色素瘤患者[18F]FDG PET/CT 上的动脉炎症：CHECK-FLAME I

背景和目的免疫检查点抑制剂（ICIs）彻底改变了癌症治疗。然而，免疫检查点抑制剂可能会增加对非肿瘤细胞的免疫反应，从而可能导致动脉炎症加剧，增加动脉粥样硬化事件的风险。然而，恶性肿瘤可能会诱发促炎症状态，而 ICIs 与动脉炎症之间的关联仍有待明确。本研究旨在评估接受 ICIs 治疗的晚期黑色素瘤患者与未接受 ICIs 治疗的对照组患者之间动脉炎症增加的差异。方法这项回顾性观察研究纳入了在基线、6 个月（T1）和 18 个月（T2）接受 [18F]FDG PET/CT 扫描的晚期黑色素瘤患者。通过计算目标与背景比值（TBR）对八个节段的动脉炎症进行了评估。主要研究结果是接受和未接受 ICIs 治疗的患者平均 TBRmax 的增加差异。在排除使用抗炎药物的情况后，接受 ICIs 治疗的患者的平均 TBRmax 在基线和 T1 之间有显著增加，从 1.29 ± 0.12 增加到 1.33 ± 0.13（p = 0.017），而对照组的平均 TBRmax 没有变化（从 1.30 ± 0.12 增加到 1.28 ± 0.10，p = 0.22）（p = 0.027）。在较长时间的随访中，两组的平均 TBRmax 均保持稳定。结论在接受 ICIs 治疗的晚期黑色素瘤患者中，仅在开始治疗后的前 6 个月内，[18F]FDG PET/CT 检测到动脉炎症显著增加，而对照组未观察到任何变化。此外，动脉炎症主要在无炎症活动和无钙化病灶的患者中增加。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.