Immune Checkpoint Inhibitors and CVD Risk in Patients With Melanoma
Source: Dermatology Advisor, December 2022
Immune checkpoint inhibitor (ICI) therapy may increase the risk for major atherosclerotic cardiovascular events in patient with high-risk or advanced melanoma, study data published in Cardio-Oncology indicates.
This retrospective cohort study enrolled patients who presented with melanoma stage II, III, or IV to an academic tertiary hospital in Victoria, Australia from 2015 through 2020. Demographic and clinical data were extracted from patients’ medical records. The exposure variable of interest was ICI treatment. The outcome of interest was any major atherosclerotic cardiovascular event (MACE), including acute myocardial infarction, ischemic stroke, acute limb ischemia, and coronary or other arterial revascularization procedure. Potential MACE events were identified from imaging reports, hospital discharge summaries, or cause of death certificates. Cox proportional hazard models were used to characterize the relationship between ICI treatment and risk of MACE. Models were adjusted for demographic and clinical covariates, including prior use of certain gene inhibition therapies.
The study cohort comprised 646 patients with melanoma, of whom 289 had been treated with ICI. Baseline demographic characteristics were comparable between treatment groups; median age was 67.9 years in the ICI treated group and 66.1 years in the non-ICI treated group. Men comprised a greater percentage of the ICI group than the non-ICI group (72.0% vs 62.5%; P =.01). Melanoma characteristics, including cancer stage and histologic subtype, were also similar between patient groups.