Evaluation of cardiovascular comorbidity in cancer patients and analysis of potential risk factors for cardiovascular complications of checkpoint inhibitor therapy

Abstract

Aim. To analyze the spectrum of cancer types and baseline cardiovascular comorbidity in patients receiving checkpoint inhibitor therapy.Material and methods. We performed retrospective analysis of case records of 112 cancer patients (55 men and 57 women) who received checkpoint inhibitor therapy in St. Petersburg hospitals. We analyzed primary tumor localizations, received immunotherapy and the initial comorbid conditions in patients.Results. The mean age of patients at the time of anticancer therapy initiation was 59,7±12,1 years for men, 57,7±14,1 years for women (p=0,249). The most common indications for immunotherapy were the following localizations: melanoma (34,8%), lungs (21,4%) and urinary system (12,5%). Among women who received checkpoint inhibitors, the lung and gynecologic cancer had the same prevalence (17,5%). The vast majority of patients (85,7%) received antiPD-1 agents, while the anti-CTLA4+anti-PD-1 combination was received by only 8,6% of patients, anti-PD-L1 monotherapy — 5,7%. Before anticancer therapy initiation, 69,6% of patients had prior CVD and/or risk factors. There were following most common comorbid conditions: hypertension — 58,9%, coronary artery disease — 36,6%, heart failure — 24,1%. At the same time, men in comparison with women were more likely to have prior stroke (12,7% vs 1,75%, respectively, p=0,024). There were no other significant sex differences between the incidence of cardiovascular diseases.Conclusion. Based on current publications describing potential risk factors for cardiovascular complications of cancer immunotherapy with checkpoint inhibitors, among the patients included in this study, 87,5% of patients can be attributed to the high-risk group.