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Acute vascular events as a possibly related adverse event of immunotherapy: a single-institute retrospective study.
Bar, Jair; Markel, Gal; Gottfried, Teodor; Percik, Ruth; Leibowitz-Amit, Raya; Berger, Raanan; Golan, Talia; Daher, Sameh; Taliansky, Alisa; Dudnik, Elizabeth; Shulman, Katerina; Urban, Damien; Onn, Amir.
Afiliação
  • Bar J; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel. Electronic address: Bar.jair@gmail.com.
  • Markel G; Sackler Faculty of Medicine, Tel Aviv University, Israel; Ella Lemelbaum Institute for Immuno-Oncology, Sheba Medical Center, Israel.
  • Gottfried T; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
  • Percik R; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel; Institute of Endocrinology, Sheba Medical Center, Israel.
  • Leibowitz-Amit R; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
  • Berger R; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
  • Golan T; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
  • Daher S; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
  • Taliansky A; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
  • Dudnik E; Thoracic Cancer Unit, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Israel.
  • Shulman K; Hillel Yaffe Medical Center, Hadera, Israel.
  • Urban D; Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
  • Onn A; Pulmonology Institute, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
Eur J Cancer ; 120: 122-131, 2019 10.
Article em En | MEDLINE | ID: mdl-31518968
AIM: Immune-related toxicities of immune checkpoint inhibitors (CPIs) require prompt diagnosis and treatment. Atherosclerosis has an inflammatory component; we speculated this inflammation could be enhanced by CPIs. We aimed to evaluate the risk of acute vascular events (AVEs) on CPIs. METHODS: Patients treated by CPIs in Sheba Medical Center (Israel) between January 2015 and May 2018 were retrospectively identified from electronic medical records. AVEs were identified and verified by chart review. Age, sex, diabetes, hypertension, smoking, dyslipidemia, previous AVE, renal failure, cancer type and specific treatments were evaluated as potential risk factors. AVE rate on CPIs was compared with that on chemotherapy or on combined chemo-immunotherapy in patients with lung adenocarcinoma. Survival of patients with AVEs was compared with that of patients without AVEs. RESULTS: CPI was administered to 1215 patients. AVEs within six months after CPI initiation occurred in 2.6% (95% confidence interval [CI]: 1.8-3.6) of patients, more common than in later time periods. In lung adenocarcinoma, event rate was 5.2% (95% CI: 2.8-9.2). Lung adenocarcinoma, prior AVE, hypertension and dyslipidemia were correlated with AVEs. AVE rate in patients with non-small cell lung cancer adenocarcinoma was similar whether on chemotherapy or on CPI. Survival of patients with AVEs was worse than that of those without AVEs. CONCLUSION: The similarly increased rates of AVEs for patients on CPI, on chemotherapy or on both suggest that although CPI may not augment the risk of AVE over that of chemotherapy, it carries a similar and significant risk of such adverse event. Caution should be exercised for patients with risk factors for AVEs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Vasculares / Antineoplásicos Imunológicos / Imunoterapia / Neoplasias Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: Eur J Cancer Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Vasculares / Antineoplásicos Imunológicos / Imunoterapia / Neoplasias Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: Eur J Cancer Ano de publicação: 2019 Tipo de documento: Article