TY - JOUR
T1 - Quantitation of cardiac troponin i in cancer patients treated with immune checkpoint inhibitors
T2 - A case-control study
AU - Ulndreaj, Antigona
AU - Brinc, Davor
AU - Altan, Mehmet
AU - Pons-Belda, Oscar D.
AU - Fernandez-Uriarte, Amaia
AU - Mu-Mosley, Hong
AU - Fattah, Farjana
AU - Von Itzstein, Mitchell S.
AU - Soosaipillai, Antoninus
AU - Kulasingam, Vathany
AU - Palaskas, Nicolas L.
AU - Gerber, David E.
AU - Diamandis, Eleftherios P.
AU - Heymach, John V.
AU - Prassas, Ioannis
N1 - Publisher Copyright:
© 2022 Walter de Gruyter GmbH, Berlin/Boston.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Objectives: Immune checkpoint inhibitors (ICIs) cause a variety of toxicities, including immune-related adverse events (irAEs), but there are no biomarkers to predict their development. Guidelines recommend measuring circulating cardiac troponin I (cTnI) during ICI therapy to detect related cardiotoxicities. Moreover, elevated cTnI has also been associated with worse outcomes in non-cardiac patients, including cancer. Thus here, we investigated whether cTnI levels were higher in patients with irAEs. Methods: The study consisted of three groups; 21 cancer patients undergoing ICI immunotherapies who presented with irAEs, four patients without irAEs, and 20 healthy controls. Patient samples were assessed at baseline (n=25), during ICI treatment (n=25, median=6 weeks of treatment) and at toxicity (n=6, median=13 weeks of treatment). In addition to blood high sensitivity cardiac troponin I (hs-cTnI), anti-thyroglobulin (TG) and anti-thyroid peroxidase (TPO) antibodies were also quantitated to detect thyroid dysfunction, constituting the second leading toxicity (23.8%) after pneumonitis (28.6%). Results: Four patients with irAEs (n=4/21; 19%) and one without irAEs (n=1/4; 25%) showed higher hs-cTnI levels at any time-point; the remaining had physiological levels. None of these patients developed cardiotoxicity. Concurrent elevated levels of anti-thyroid antibodies and hs-cTnI were detected in one patient with thyroid dysfunction (n=1/5, 20%). However, these antibodies were also elevated in three patients (n=3/16, 19%) with non-thyroid irAEs and in up to 40% of healthy controls. Conclusions: hs-cTnI was not elevated in patients with irAEs, but larger studies are needed to confirm these observations.
AB - Objectives: Immune checkpoint inhibitors (ICIs) cause a variety of toxicities, including immune-related adverse events (irAEs), but there are no biomarkers to predict their development. Guidelines recommend measuring circulating cardiac troponin I (cTnI) during ICI therapy to detect related cardiotoxicities. Moreover, elevated cTnI has also been associated with worse outcomes in non-cardiac patients, including cancer. Thus here, we investigated whether cTnI levels were higher in patients with irAEs. Methods: The study consisted of three groups; 21 cancer patients undergoing ICI immunotherapies who presented with irAEs, four patients without irAEs, and 20 healthy controls. Patient samples were assessed at baseline (n=25), during ICI treatment (n=25, median=6 weeks of treatment) and at toxicity (n=6, median=13 weeks of treatment). In addition to blood high sensitivity cardiac troponin I (hs-cTnI), anti-thyroglobulin (TG) and anti-thyroid peroxidase (TPO) antibodies were also quantitated to detect thyroid dysfunction, constituting the second leading toxicity (23.8%) after pneumonitis (28.6%). Results: Four patients with irAEs (n=4/21; 19%) and one without irAEs (n=1/4; 25%) showed higher hs-cTnI levels at any time-point; the remaining had physiological levels. None of these patients developed cardiotoxicity. Concurrent elevated levels of anti-thyroid antibodies and hs-cTnI were detected in one patient with thyroid dysfunction (n=1/5, 20%). However, these antibodies were also elevated in three patients (n=3/16, 19%) with non-thyroid irAEs and in up to 40% of healthy controls. Conclusions: hs-cTnI was not elevated in patients with irAEs, but larger studies are needed to confirm these observations.
KW - anti-thyroid autoantibodies
KW - cancer immunotherapy
KW - cardiac troponin I
KW - case-control study
KW - immune checkpoint inhibitors
KW - immune-related adverse events
KW - predictive biomarkers
KW - prognostic biomarkers
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U2 - 10.1515/cclm-2022-0471
DO - 10.1515/cclm-2022-0471
M3 - Article
C2 - 36287134
AN - SCOPUS:85141042597
SN - 1434-6621
VL - 61
SP - 154
EP - 161
JO - Clinical Chemistry and Laboratory Medicine
JF - Clinical Chemistry and Laboratory Medicine
IS - 1
ER -