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- Title
Quantitation of cardiac troponin I in cancer patients treated with immune checkpoint inhibitors: a case-control study.
- Authors
Ulndreaj, Antigona; Brinc, Davor; Altan, Mehmet; Pons-Belda, Oscar D.; Fernandez-Uriarte, Amaia; Mu-Mosley, Hong; Fattah, Farjana; von Itzstein, Mitchell S.; Soosaipillai, Antoninus; Kulasingam, Vathany; Palaskas, Nicolas L.; Gerber, David E.; Diamandis, Eleftherios P.; Heymach, John V.; Prassas, Ioannis
- Abstract
Immune checkpoint inhibitors (ICIs) cause a variety of toxicities, including immune-related adverse events (irAEs), but there are no biomarkers to predict their development. Guidelines recommend measuring circulating cardiac troponin I (cTnI) during ICI therapy to detect related cardiotoxicities. Moreover, elevated cTnI has also been associated with worse outcomes in non-cardiac patients, including cancer. Thus here, we investigated whether cTnI levels were higher in patients with irAEs. The study consisted of three groups; 21 cancer patients undergoing ICI immunotherapies who presented with irAEs, four patients without irAEs, and 20 healthy controls. Patient samples were assessed at baseline (n=25), during ICI treatment (n=25, median=6 weeks of treatment) and at toxicity (n=6, median=13 weeks of treatment). In addition to blood high sensitivity cardiac troponin I (hs-cTnI), anti-thyroglobulin (TG) and anti-thyroid peroxidase (TPO) antibodies were also quantitated to detect thyroid dysfunction, constituting the second leading toxicity (23.8%) after pneumonitis (28.6%). Four patients with irAEs (n=4/21; 19%) and one without irAEs (n=1/4; 25%) showed higher hs-cTnI levels at any time-point; the remaining had physiological levels. None of these patients developed cardiotoxicity. Concurrent elevated levels of anti-thyroid antibodies and hs-cTnI were detected in one patient with thyroid dysfunction (n=1/5, 20%). However, these antibodies were also elevated in three patients (n=3/16, 19%) with non-thyroid irAEs and in up to 40% of healthy controls. hs-cTnI was not elevated in patients with irAEs, but larger studies are needed to confirm these observations.
- Subjects
IMMUNE checkpoint inhibitors; TROPONIN I; DRUG side effects; CANCER patients; CASE-control method; COPEPTINS; MICROFILAMENT proteins
- Publication
Clinical Chemistry & Laboratory Medicine, 2023, Vol 61, Issue 1, p154
- ISSN
1434-6621
- Publication type
Article
- DOI
10.1515/cclm-2022-0471