Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

e-Poster Display Session

41P - Cardiotoxicity of immune checkpoint inhibitors: A meta-analysis of randomized clinical trials

Date

09 Dec 2020

Session

e-Poster Display Session

Topics

Immunotherapy;  Supportive Care and Symptom Management

Tumour Site

Presenters

Elisa Agostinetto

Citation

Annals of Oncology (2020) 31 (suppl_7): S1428-S1440. 10.1016/annonc/annonc391

Authors

E. Agostinetto1, D. Eiger1, M. Lambertini2, M. Ceppi2, M. Bruzzone2

Author affiliations

  • 1 Institut Jules Bordet, Brussels/BE
  • 2 IRCCS Ospedale Policlinico San Martino, Genova/IT
More

Abstract 41P

Background

Immune-checkpoint inhibitors (ICI) can cause potentially life-threatening adverse events (AE). However, their risk of cardiotoxicity has been poorly investigated. It is also unknown whether ICI combinations increases cardiotoxicity compared to single ICI. We aimed to assess the cardiotoxicity of ICI compared to other cancer treatments (primary objective) and of dual-agent ICI (immunotherapy combinations) compared to single-agent ICI (secondary objective).

Methods

This systematic review and meta-analysis (M-A) was conducted according to the PRISMA guidelines and was registered in the PROSPERO database with the ID number CRD42020183524. A systematic search of PubMed, MEDLINE, Embase databases, and conference proceedings was performed up to June 30, 2020. All randomized clinical trials comparing ICI vs other treatments (primary objective) or dual-agent ICI vs single-agent ICI (secondary objective) in all solid tumors were included. Pooled risk ratios (RR) with 95% confidence intervals (95% CI) for cardiotoxicity events were calculated using random effect models. Two distinct M-A were performed to address the primary and secondary objectives.

Results

Eighty studies including 35,337 patients (pts) were included in the analysis (66 studies with 34,664 pts for primary objective and 14 studies with 673 pts for secondary objective). No statistically significant differences in terms of cardiac AE were observed between the ICI and non-ICI groups nor between the dual-ICI and single-ICI groups. The table reports on pooled incidence of cardiac AE and relative RR with 95% CI. No statistically significant differences were observed in the subgroup analyses according to tumor type, setting of disease, treatment line and type of treatment. Table: 41P

Incidence of cardiac AE

ICI-group (%) Non-ICI group (%) RR (95% CI) Dual-ICI group (%) Single-ICI group (%) RR (95% CI)
Any cardiac AE 3.78 3.40 1.14 (0.88-1.48) 2.87 0.40 1.91 (0.52-7.01)
Myocarditis 0.12 0.01 1.11 (0.64-1.92) 0.17 0 1.10 (0.31-3.87)
Myocardial infarction 0.41 0.27 1.19 (0.63-2.23) 0.50 0 0.98 (0.21-4.47)
Pericarditis 0.51 0.22 1.14 (0.62-2.10) 0 0.49 0.67 (0.16-2.76)
Arrhytmias 1.79 1.49 1.32 (0.94-1.84) 2.48 0 1.65 (0.40-6.89)
Heart failure 0.43 0.63 0.61 (0.35-1.07) 0.38 0 1.04 (0.25-4.26)
Valvular disease 0 0.03 0.63 (0.24-1.64) 0 0 0.79 (0.16-3.83)
Cardiac arrest 0.24 0.09 1.23 (0.61-2.47) 0 0 0.79 (0.16-3.83)
Cardiac death 0.33 0.21 1.07 (0.72-1.59) 0.27 0 1.28 (0.48-3.42)

Conclusions

Use of ICI as single or combination regimens is not associated with increased risk of cardiotoxicity.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

D. Eiger: Research grant/Funding (self), Funding for his ESMO fellowship (2018-2019): Novartis: Novartis. M. Lambertini: Honoraria (self), Advisory/Consultancy: Roche; Honoraria (self), Advisory/Consultancy: Novartis; Honoraria (self): Theramex; Honoraria (self): Takeda; Honoraria (self): Lilly; Honoraria (self): Pfizer. N.F. Pondé: Honoraria (self), Advisory/Consultancy: Lilly; Honoraria (self): Roche; Honoraria (self): Novartis; Honoraria (self): AstraZeneca. A.H. Awada: Honoraria (institution), Speaker Bureau/Expert testimony: Roche; Honoraria (institution), Speaker Bureau/Expert testimony: Lilly; Honoraria (institution), Speaker Bureau/Expert testimony: Amgen; Honoraria (institution), Speaker Bureau/Expert testimony: EISAI; Honoraria (institution), Speaker Bureau/Expert testimony: BMS; Honoraria (institution), Speaker Bureau/Expert testimony: Pfizer; Honoraria (institution), Speaker Bureau/Expert testimony: Novartis; Honoraria (institution), Speaker Bureau/Expert testimony: MSD; Honoraria (institution), Speaker Bureau/Expert testimony: Genomic Health; Honoraria (institution), Speaker Bureau/Expert testimony: Ipsen; Honoraria (institution), Speaker Bureau/Expert testimony: AstraZeneca; Honoraria (institution), Speaker Bureau/Expert testimony: Bayer; Honoraria (institution), Speaker Bureau/Expert testimony: Leo Pharma. M. Piccart: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Board Member (Scientific Board): Oncolytics; Honoraria (institution), Speaker Bureau/Expert testimony, Board Member (Scientific Board): Radius; Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Honoraria (self), Advisory/Consultancy: Camel-IDS; Honoraria (self), Advisory/Consultancy: Crescendo Biologics; Honoraria (self), Advisory/Consultancy: Debiopharm; Honoraria (self), Advisory/Consultancy: G1 Therapeutics; Honoraria (self), Honoraria (institution), Advisory/Consultancy: Genentech; Honoraria (self), Advisory/Consultancy: Huya; Honoraria (self), Advisory/Consultancy: Immunomedics; Honoraria (self), Honoraria (institution), Advisory/Consultancy: Lilly; Honoraria (self), Advisory/Consultancy: Menarini; Honoraria (self), Honoraria (institution), Advisory/Consultancy: MSD; Honoraria (self), Honoraria (institution), Advisory/Consultancy: Novartis; Honoraria (self), Advisory/Consultancy: Odonate; Honoraria (self), Advisory/Consultancy: Periphagen; Honoraria (self), Honoraria (institution), Advisory/Consultancy: Pfizer; Honoraria (self), Honoraria (institution), Advisory/Consultancy: Roche; Honoraria (self), Advisory/Consultancy: Seattle Genetics; Honoraria (institution): Servier. E. de Azambuja: Honoraria (self), Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: Roche/GNE; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: Novartis; Honoraria (self), Advisory/Consultancy: Seattle Genetics; Travel/Accommodation/Expenses: GSK; Honoraria (institution): AstraZeneca; Honoraria (institution): Servier. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.