Cardiovascular risk factor reporting in immune checkpoint inhibitor trials: A systematic review.


Journal

Cancer epidemiology
ISSN: 1877-783X
Titre abrégé: Cancer Epidemiol
Pays: Netherlands
ID NLM: 101508793

Informations de publication

Date de publication:
04 2023
Historique:
received: 13 11 2022
revised: 04 01 2023
accepted: 14 01 2023
pubmed: 21 1 2023
medline: 15 3 2023
entrez: 20 1 2023
Statut: ppublish

Résumé

Immune checkpoint inhibitors (ICI) have revolutionized the treatment of numerous cancers but are associated with increased risk of myocardial infarction. The prevalence of traditional cardiovascular risk factors (CVRF) in patients treated with ICIs is unknown. This study sought to describe the frequency of reporting of CVRFs among landmark ICI trials. A systematic review of all phase 2 or 3 cancer trials employing ICIs that led to United States Food and Drug Administration approval was conducted. Of the 69 identified trials, only one study reported baseline rates of hypertension, diabetes mellitus, and dyslipidemia. Smoking history was reported in 27 studies (39 %) and three (4 %) reported body mass index. No study reported history of previous cardiovascular disease, although 17 (25 %), six (9 %), and 21 (30 %) studies excluded patients with recent myocardial infarction, revascularization and heart failure respectively. Similarly low rates of cardiovascular risk factor reporting were observed in studies employing concurrent vascular endothelial growth factor inhibitors and recruiting (neo)adjuvant cohorts. The prevalence of CVRFs is poorly described in ICI trials despite increasingly reported risks of myocardial infarction. A systematic approach to collecting and reporting CVRFs should be considered in future trials and real world populations.

Sections du résumé

BACKGROUND
Immune checkpoint inhibitors (ICI) have revolutionized the treatment of numerous cancers but are associated with increased risk of myocardial infarction. The prevalence of traditional cardiovascular risk factors (CVRF) in patients treated with ICIs is unknown. This study sought to describe the frequency of reporting of CVRFs among landmark ICI trials.
METHODS
A systematic review of all phase 2 or 3 cancer trials employing ICIs that led to United States Food and Drug Administration approval was conducted.
RESULTS
Of the 69 identified trials, only one study reported baseline rates of hypertension, diabetes mellitus, and dyslipidemia. Smoking history was reported in 27 studies (39 %) and three (4 %) reported body mass index. No study reported history of previous cardiovascular disease, although 17 (25 %), six (9 %), and 21 (30 %) studies excluded patients with recent myocardial infarction, revascularization and heart failure respectively. Similarly low rates of cardiovascular risk factor reporting were observed in studies employing concurrent vascular endothelial growth factor inhibitors and recruiting (neo)adjuvant cohorts.
CONCLUSION
The prevalence of CVRFs is poorly described in ICI trials despite increasingly reported risks of myocardial infarction. A systematic approach to collecting and reporting CVRFs should be considered in future trials and real world populations.

Identifiants

pubmed: 36669376
pii: S1877-7821(23)00014-0
doi: 10.1016/j.canep.2023.102334
pii:
doi:

Substances chimiques

Immune Checkpoint Inhibitors 0
Vascular Endothelial Growth Factor A 0

Types de publication

Systematic Review Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

102334

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Sean Tan (S)

Victorian Heart Institute, Melbourne, Australia; Monash Heart, Monash Health, Melbourne, Australia. Electronic address: Sean.Tan@monash.edu.

Seiyon Sivakumar (S)

Monash University, Melbourne, Australia.

Eva Segelov (E)

Monash University, Melbourne, Australia.

Stephen J Nicholls (SJ)

Victorian Heart Institute, Melbourne, Australia; Monash Heart, Monash Health, Melbourne, Australia.

Adam J Nelson (AJ)

Victorian Heart Institute, Melbourne, Australia; Monash Heart, Monash Health, Melbourne, Australia.

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Classifications MeSH