在接受和没有免疫检查点抑制剂治疗的黑色素瘤患者中[18F] FDG PET/CT的动脉炎症：检查型I
Arterial inflammation on [18F]FDG PET/CT in melanoma patients treated with and without immune checkpoint inhibitors: CHECK-FLAME I
影响因子:5.70000
分区:医学2区 Top / 外周血管病2区 心脏和心血管系统3区
发表日期:2024 Nov
作者:
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
摘要
免疫检查点抑制剂（ICIS）彻底改变了癌症治疗。但是，ICI可能会增加对非肿瘤细胞的免疫反应，可能导致动脉炎症增加，从而增加了动脉粥样硬化事件的风险。然而，恶性肿瘤可能会引起促炎性状态，ICIS与动脉炎症之间的关联仍然有待澄清。这项研究旨在评估与没有ICIS的对照组相比，接受ICIS晚期黑色素瘤患者的动脉炎症增加的差异。患有晚期黑色素瘤患者在基线时接受[18F] FDG PET/CT扫描，6个月（T1）和18个月（T1）（T2）（T2）。通过计算目标与背景比（TBR）来评估八个部分中的动脉炎症。主要研究结果是接受和不接受ICIS治疗的患者之间平均TBRMAX的增加差异。我们包括132名患者，其中72.7％接受了ICIS治疗。 After exclusion for the use of anti-inflammatory medication, patients treated with ICIs showed a significant increase in mean TBRmax 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 TBRmax (1.30 ± 0.12 to 1.28 ± 0.10, p = 0.22) was observed (p = 0.027).在更长的随访期间，平均TBRMAX在两组中保持稳定。 ICI治疗后，没有活性炎症的患者（P <0.001）和没有钙化的患者（p = 0.013）的患者的动脉炎症显着增加。在[18F] FDG PET/CT上测量的动脉炎症显着增加，仅在未经ICIS治疗的患者中，在开始后六个月内就观察到了ICIS的患者，而在启动治疗后，没有观察到ICIS的患者，而在治疗后的六个月内，才观察到。此外，没有预先存在的炎症活性和非钙化病变的患者主要增加了动脉炎症。
Abstract
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.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 TBRmax between patients treated with and without ICIs.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 TBRmax 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 TBRmax (1.30 ± 0.12 to 1.28 ± 0.10, p = 0.22) was observed (p = 0.027). During longer follow-up, mean TBRmax 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).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.