ObjectiveAntimicrotubular agents are among the most commonly used classes of chemotherapeutic agents, but the risk of cardiovascular adverse events (CVAEs) remains unclear. Our objective was to study the CVAEs associated with antimicrotubular agents.MethodsThe Food and Drug Administration’s Adverse Event Reporting System was used to study CVAEs in adults from 1990 to 2020. Reported single-agent (only taxane or vinca alkaloid) CVAEs were compared with combination therapy (with at least one of the four major cardiotoxic drugs: anthracycline, HER2Neu inhibitors, tyrosine kinase inhibitors and checkpoint inhibitors) using adjusted polytomous logistic regression.ResultsOver 30 years, 134 398 adverse events were reported, of which 18 426 (13.4%) were CVAEs, with 74.1% due to taxanes and 25.9% due to vinca alkaloids. In 30 years, there has been a reduction in the proportion of reported CVAEs for taxanes from 15% to 11.8% (Cochran-Armitage P-trends <0.001) with no significant change in the proportion of reported CVAEs for vinca alkaloids (9.2%–11.7%; P-trends=0.06). The proportion of reported CVAEs was lower in both taxane and vinca alkaloid monotherapy versus combination therapy (reporting OR=0.50 and 0.55, respectively). Anthracyclines and HER2Neu inhibitor combinations with taxanes or vinca alkaloids primarily drove the higher burden of combination CVAEs. Hypertension requiring hospitalisation and heart failure was significantly lower in monotherapy versus combination antimicrotubular agent therapy.ConclusionsAntimicrotubular agents are associated with CVAEs, especially in combination chemotherapy regimens. Based on this study, we suggest routine cardiovascular assessment of patients with cancer before initiating antimicrotubular agents in combination therapy.
More than 30 % of the German population are regular smokers, over half of whom will eventually die of smoking-related diseases. Life expectancy is abridged by 10 years in smokers compared to non-smokers. Smoking tobacco is the main risk factor for lung cancer and chronic obstructive pulmonary disease (COPD) and predisposes to a number of other lung diseases. A smoking cessation programme including pharmacological as well as psychosocial support is highly effective in COPD Patients. Smoking cessation improves lung function, symptoms and mortality. In conclusion, smoking cessation services are among the most effective medical interventions. Thus, a sufficient supply of smoking cessation services on a population level must be ensured.
2596 Background: The presence or lack of a collection of antigenic cell surface markers on red blood cells makes up the ABO blood groups that contribute to various immunogenic neoantigens. Variations in the T-cell diversity and HLA haplotype with different blood types might affect a patient's response to Immune checkpoint inhibitors (ICIs). However, the association between the ABO blood type and ICIs is not well studied. Methods: We did a retrospective observational study to investigate the influence of ABO blood groups on patients receiving ICIs at the University of Vermont Cancer Centre. We examined the medical records of people who received ICIs as first-line therapy between January 2017 and June 2022 and collected demographic data, including age, sex, ethnicity, cancer stage, type and metastasis. We looked at overall survival and the occurrence of immune-related adverse events (irAEs) in different blood type subgroups and calculated relative risks. Results: A total of 288 cases were identified, out of which 169 had documented blood type, including 75 with A, 19 with B, 72 with O and 3 with AB blood type. The mean age was 63.71 years (Standard deviation (SD): 11.52), 58.6% were males, and ethnicity was 94.7% White, 1.2% Asian and 0.6% Hispanic. Lung cancer was most commonly identified at 41%, and 60% of total cancers were stage 4. The median ECOG status was 1 and the Charlson comorbidity index was 6. 36% of cases developed irAEs, whereas mortality was 39% during the study period. The relative risk of irAEs with blood type A and B compared to O was 0.89 and 0.83, respectively but wasn't statistically significant. The relative risk of irAEs of AB compared to O blood type was statistically significant at 2.63 (CI: 1.95-3.54). The relative risk of death in A and B blood types compared to O wasn't statistically significant. No patients in the AB blood group died. Conclusions: Clinically significant association wasn't found between different blood types and irAEs or mortality except for the increased risk of irAEs with AB compared to O. With the rapidly growing use of ICIs, prospective trials are needed to better understand the true risk of developing irAEs in patients with AB blood type. [Table: see text]
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