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QTC INTERVAL PROLONGATION, DECREASED TOTAL ATRIAL CONDUCTION TIME, AND INCREASED PRO-BNP LEVELS ASSOCIATED WITH IMMUNE CHECKPOINT INHIBITORS: AN OBSERVATIONAL, PROSPECTIVE, SURVEILLANCE STUDY

CANAN KARAN,, IPEK BUBER,, CİHAN ILYAS SEVGİCAN,, ARZU YAREN,, ISMAİL DOGU KIİLİC

Eurasian Journal of Medical Investigation - 2025;9(2):64-71

Department of Oncology, Gaziantep Liv Hospital, Gaziantep, Türkiye

 

Objectives: We aimed to investigate potential cardiotoxic effects in patients with cancer treated with PD-1/PD-L1 inhibitors. Methods: In this prospective observational cohort study, 52 cancer patients received immunotherapy in a tertiary care hospital. After elimination, 33 patients underwent at least two evaluations, and their examinations were analyzed. The electrocardiographic and echocardiographic assessment was performed on the first visit before ICI administration and three months after treatment. Results: The mean age was 62 years. Thirty patients were at the metastatic stage. Most patients had non-small cell lung cancer, and 84% of patients had received anti-cancer treatment previously. Pro-BNP levels were higher in the post-treatment period (273.13±56.15 pg/mL vs. 812.32±419.1pg/mL; p=0.034; pre- and post-treatment, respectively). For Left ventricular stroke volume (LVSV) and cardiac output (CO) were lower in the post-treatment period (for LVSV: 61.19±13.72 mL vs. 57.80±10.15 mL; p=0.049; for CO: 5.00±1.14 L/min vs. 4.69±0.85 L/min, p=0.048). QTc interval was prolonged post-treatment period (433.57±26.19 msec vs. 451.86±39.41 msec; p=0.029; pre- and post-treatment, respectively). Total atrial conduction time was shorter in the post-treatment period (106.87±17.76 msec vs. 101.19±14.74 msec; p = 0.009; pre- and post-treatment, respectively). Conclusion: Increased pro-BNP levels, prolonged QTc interval, and decreased total atrial conduction time were observed at short-term follow-up after ICI treatment.