Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Moik, F; Riedl, JM; Barth, D; Berton, F; Fink, M; Englisch, C; Hoeller, C; Fuereder, T; Ay, L; Pabinger, I; Richtig, E; John, N; Kostmann, SM; Jost, PJ; Gerger, A; Terbuch, A; Preusser, M; Ay, C.
Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors
JACC-CARDIOONCOL. 2024; 6(6): 965-975.
Doi: 10.1016/j.jaccao.2024.09.007
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- Führende Autor*innen der Med Uni Graz
- Moik Florian
- Co-Autor*innen der Med Uni Graz
- Barth Dominik Andreas
- Berton Franziska
- Fink Michael
- Gerger Armin
- John Nikolaus
- Jost Philipp
- Kostmann Sarah Madelaine
- Richtig Erika
- Riedl Jakob
- Terbuch Angelika
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- Abstract:
- BACKGROUND: Patients with cancer treated with immune-checkpoint inhibitors (ICIs) have a substantial risk of venous thromboembolism (VTE). The association between ICI-induced inflammation and hypercoagulability is unclear, and no biomarkers currently exist to stratify VTE risk. OBJECTIVES: The authors sought to determine the association between the early changes in C-reactive protein (CRP) after ICI initiation and the risk of VTE. METHODS: This retrospective cohort study included patients with cancer initiating ICI therapy from 2 academic cancer centers, serving as discovery and external validation cohorts. Patients were stratified based on CRP trajectories during the first 3 months of ICI treatment, with a CRP rise defined as a 2-fold increase from baseline. Patients were followed for VTE for the duration of ICI therapy, and competing risk and time-dependent analyses were used. RESULTS: A total of 822 patients were included. In the discovery cohort (n = 405), the cumulative VTE incidence in patients with a CRP rise (n = 159, 39.3%) was 19.9% (95% CI: 8.4%-34.8%), compared with 8.6% (3.1%-17.6%) in those without a CRP rise. After adjusting for key patient- and cancer-specific confounders, the subdistribution HR for VTE in patients with a CRP rise was 2.64 (95% CI: 1.06-6.62). This was confirmed in the external validation cohort (n = 417; subdistribution HR: 2.25; 95% CI: 1.03-4.94), with VTE incidences of 22.9% (95% CI: 9.7%-39.3%) in patients with a CRP rise and 10.8% (95% CI: 7.4%-15.1%) in those without. The association between CRP rise and VTE risk was confirmed in a time-dependent analysis and was consistent after adjusting for disease progression as a potential time-dependent confounder. CONCLUSIONS: Early CRP changes during ICI therapy are associated with an increased risk of VTE, suggesting a potential association between ICI-induced inflammation and hypercoagulability. CRP trajectories may serve as a biomarker for ICI-associated VTE.
- Find related publications in this database (Keywords)
- cancer
- C-reactive protein
- immune checkpoint inhibitors
- thrombosis
- venous thromboembolism