Recipients of the revolutionary checkpoint inhibitor drugs have faced a significantly increased risk of cardiovascular disease, researchers report today.
The risk from the immunotherapy drugs has been investigated by a team from Copenhagen University Hospital in Denmark.
Dr Maria D’Souza and colleagues set out to estimate the risk of cardiac events in patients with lung cancer or malignant melanoma treated with immune checkpoint inhibitors.
The study appears in the European Heart Journal today (9 December). They explain that in the last decade, immune checkpoint inhibitors “have revolutionised the therapeutic landscape of many cancers and can significantly improve prognosis”, but may cause immune-related mild to moderate side-effects in organs in up to 40% of patients.
In particular, the cardiac side-effects – arrhythmias, myocarditis, heart failure, and sudden cardiac arrest – are “widely uninvestigated”, say the team.
They looked at 25,573 patients with lung cancer and 13,568 with malignant melanoma, treated in 2011 to 2017.
This showed that the rates of cardiac events were higher in patients given immune checkpoint inhibitor treatment.
Within six months of first treatment, the rate was 2.14 times higher in patients with lung cancer given immune checkpoint inhibitors. The rate was 4.3 to 4.9 times higher in patients with malignant melanoma given immune checkpoint inhibitors, depending on the form of medication.
After six months, the rates were 2.26 and 3.48 times higher for these patient groups.
Dr D’Souza commented: “We found that these risks were higher than previously estimated by drug safety studies. Previous studies have shown that most adverse side-effects that affect the heart occur early after treatment has started, within the first few weeks or months. However, our results suggest that an increased risk of heart problems continues beyond the initial six months.
“We hope that this information may be useful for making doctors aware that extra attention needs to be given to patients treated with immune checkpoint inhibitors.”
D’Souza, M. et al. A risk of cardiac events in patients receiving immune checkpoint inhibitors: a nationwide Danish study. European Heart Journal 9 December 2020; doi: 10.1093/eurheartj/ehaa884
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