Early evaluation of subclinical cardiotoxicity in patients with lung cancer receiving immune checkpoint inhibitors by cardiovascular magnetic resonance: a prospective observational study

Liu, Jia; Cao, Yukun; Zhu, Kuikui; Yao, Sheng; Yuan, Ming; Kong, Xiaodong; Liu, Xiaoming; Li, Yumin; Cui, Yue; Han, Xiaoyu; Zhou, Xiaoyue; Ma, Rui; Shi, Heshui

doi:10.21037/qims-22-41

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Исследование пациентов с раком легких, получавших терапию ингибиторами контрольных точек, показало, что предсказать развитие субклинической КТ с помощью МРТ можно через 3 месяца после ХТ. Данный вывод был основан на полученных данных об относительном снижении показателя глобальной радиальной деформации ЛЖ (29,8% ± 25,8% P = 0,036) [64].…”

Section: результаты исследованияunclassified

Promising approaches to noninvasive diagnosis of subclinical cardiovascular toxicity of chemotherapy

Khardikova,

Meshcherina,

Mikhailenko

et al. 2024

Humans and their Health

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Objective: to present data on available modern methods of diagnosis of subclinical cardiovascular toxicity of chemotherapy. Modern strategies of treatment of cancer allow to stable remission and increase life expectancy of patients, the success of which is balanced by increased mortality of cancer patients due to the development of side effects of chemotherapy, the most prognostically significant of which are cardiovascular complications. Early diagnosis of cardiovascular toxicity in cancer patients is a “new” priority for collaboration of oncologists and cardiologists, as the development or progression of an already existing heart disease has a significant impact on the duration and quality of life of cancer patients. This review, at the current level of development of medical science, presents methods of diagnosis and monitoring of subclinical cardiovascular toxicity against the background of chemotherapy. Use for the diagnosis of subclinical cardiotoxicity such modern methods of visualization as two- and three-dimensional echocardiography, echocardiography with the definition of global longitudinal deformation of the myocardium - spectrum-tracking echocardiography, myocardial work, magnetic resonance tomography, definition of diastolic dysfunction allows to identify manifestations of cardiovascular toxicity in earlier terms, thereby affecting the prognosis and quality of life in cancer patients receiving chemotherapy treatment.

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Section: результаты исследованияunclassified

Promising approaches to noninvasive diagnosis of subclinical cardiovascular toxicity of chemotherapy

Khardikova,

Meshcherina,

Mikhailenko

et al. 2024

Humans and their Health

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An unusual ectopic thymoma clonal evolution analysis: A case report

Zhang

et al. 2023

Open Life Sciences

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Thymomas and thymic carcinomas are rare and primary tumors of the mediastinum which is derived from the thymic epithelium. Thymomas are the most common primary anterior mediastinal tumor, while ectopic thymomas are rarer. Mutational profiles of ectopic thymomas may help expand our understanding of the occurrence and treatment options of these tumors. In this report, we sought to elucidate the mutational profiles of two ectopic thymoma nodules to gain deeper understanding of the molecular genetic information of this rare tumor and to provide guidance treatment options. We presented a case of 62-year-old male patient with a postoperative pathological diagnosis of type A mediastinal thymoma and ectopic pulmonary thymoma. After mediastinal lesion resection and thoracoscopic lung wedge resection, the mediastinal thymoma was completely removed, and the patient recovered from the surgery and no recurrence was found by examination until now. Whole exome sequencing was performed on both mediastinal thymoma and ectopic pulmonary thymoma tissue samples of the patient and clonal evolution analysis were further conducted to analyze the genetic characteristics. We identified eight gene mutations that were co-mutated in both lesions. Consistent with a previous exome sequencing analysis of thymic epithelial tumor, HRAS was also observed in both mediastinal lesion and lung lesion tissues. We also evaluated the intratumor heterogeneity of non-silent mutations. The results showed that the mediastinal lesion tissue has higher degree of heterogeneity and the lung lesion tissue has relatively low amount of variant heterogeneity in the detected variants. Through pathology and genomics sequencing detection, we initially revealed the genetic differences between mediastinal thymoma and ectopic thymoma, and clonal evolution analysis showed that these two lesions originated from multi-ancestral regions.

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Cardiovascular Monitoring of Cancer Patients Undergoing Immune Checkpoint Inhibitor Therapy: Preliminary Results from a Prospective Observational Study

Kushnareva,

Gavriluk,

Shuginova

et al. 2023

Preprint

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Background: the whole spectrum of Immune Checkpoint Inhibitors (ICI) associated cardiovascular immune related adverse events is not fully understood. Only last years it became clear that ICI may cause not only inflammatory cardiovascular diseases. And recent prospective studies have shown subclinical left ventricular disfunction progression in patients treated with ICI but results are bit discordant. Also, specific risk factors of ICI related cardiovascular adverse events didn’t clear yet. Methods: single canter prospective observational study enrolled sixty patients with cancer and indications for ICI. All patients underwent cardiovascular examination before antitumor therapy (n=60), as well as at 3 months (n=34) and 9 months (n=15) following its initiation. The standard examination protocol included evaluation of laboratory parameters, echocardiographic assessment (incl. left ventricular deformation characteristics), Holter monitoring, carotid ultrasound. Results: no statistically significant changes were observed in serum creatinine, C-reactive protein, troponin I, NT-proBNP, and thyroid-stimulating hormone. At the 3-month follow-up, left ventricular (LV) end-systolic volume (ESV) increased from 38±12 ml to 41±11 ml (p=0.026), while LV ejection fraction (EF) decreased from 64% [61;66] to 62% [58;66] (p=0.043). After 9 months patients displayed a continued increase in LV ESV from 35±10 ml to 40±9 ml (p=0.044) and a decrease in LV EF from 64±4% to 60±6% (p=0.012). Additionally, there were observed increases in the diameter of the aortic sinuses of Valsalva (p=0.012), ascending aorta (p=0.046), left atrium (p=0.013), and right ventricle (p=0.011). There was a notable increase in the proportion of patients with atherosclerotic lesions in the carotid arteries, rising from 44% to 60% over the 3-month period (p=0.046). Throughout the follow-up period, novel cardiovascular events occurred in 23.3% of patients (n=14) and included asymptomatic decrease in LV EF and GLS, meeting the established criteria for cardiotoxicity. According to univariate Cox regression analysis, several independent predictors of new CVEs were identified included creatinine, left ventricular Tei index, initial NT-proBNP exceeding 500 pg/ml, TSH concentration, and treatment with anti-PD-L1 immune checkpoint inhibitor. Conclusion: we reveled the high incidence of novel cardiovascular events, presence of subclinical changes of echocardiography parameters, atherosclerosis progression. Also, we defined predictors of ICI related cardiovascular adverse events.

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Early evaluation of subclinical cardiotoxicity in patients with lung cancer receiving immune checkpoint inhibitors by cardiovascular magnetic resonance: a prospective observational study

Cited by 3 publications

References 38 publications

Promising approaches to noninvasive diagnosis of subclinical cardiovascular toxicity of chemotherapy

Promising approaches to noninvasive diagnosis of subclinical cardiovascular toxicity of chemotherapy

An unusual ectopic thymoma clonal evolution analysis: A case report

Cardiovascular Monitoring of Cancer Patients Undergoing Immune Checkpoint Inhibitor Therapy: Preliminary Results from a Prospective Observational Study

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