Abstract 291P
Background
Immune checkpoint inhibitors (ICIs) have made significant progress in cancer therapy, particularly in solid tumors. However, ICI-associated cardiotoxicity remains a severe and potentially life-threatening adverse event. Given the frequent use of ICIs in renal cell carcinoma (RCC), this study aimed to evaluate their cardiotoxic effects in this patient population.
Methods
A systematic search was conducted on PubMed, Web of Science, Scopus, and Embase for phase II/III randomized controlled trials of ICIs in RCC up to July 2024. Outcomes of interest included the incidence of hypertension, major adverse cardiac events (MACE), heart failure (HF), atrial fibrillation (AF), and grade 3-4 adverse effects (hypertension, venous thromboembolic events (VTE)). The incidence of cardiotoxicity events was pooled using inverse-variance, random (I2>50%) or fixed (I2<50%) models meta-analysis for single proportion studies, calculated with logit transformation in RStudio.
Results
A total of 11 RCTs, including 7472 patients, were analyzed. The pooled incidence of hypertension was 39% (95% CI, 37-41; I2=98%, p < 0.0001), with grade ≥ 3 hypertension at 19% (95% CI, 17-20, I2=95%, p < 0.0001). MACE occurred in 1% of patients (95% CI, 1-2, I2=39%), grade 3-4 VTE in 1% (95% CI, 1-2, I2=0%), and HF and AF incidences were <1%.
Conclusions
The use of ICIs in RCC patients revealed a significant incidence of cardiotoxicity, particularly hypertension. Although the incidence of MACE, HF, and AF is relatively low, the high prevalence of hypertension and grade 3-4 adverse events necessitates careful monitoring and management in clinical practice.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.