We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Biomarkers Associated With Immune Checkpoint Inhibitor Myocarditis Revealed

By LabMedica International staff writers
Posted on 27 Dec 2022
Print article
Image: Histopathological characteristics of immune checkpoint inhibitor–associated myocarditis (Photo courtesy of The University of Texas MD Anderson Cancer Center)
Image: Histopathological characteristics of immune checkpoint inhibitor–associated myocarditis (Photo courtesy of The University of Texas MD Anderson Cancer Center)

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of various malignancies. The development and widespread use of ICIs have led to improved outcomes with a generally better tolerated side-effect profile compared with other therapies.

Immune-related adverse events (irAEs), while infrequent, are a direct result of the mechanism of action of ICIs, with disinhibition of T cells leading to a complex cascade of dysregulation of immune self-tolerance that can occur in almost any organ system. Myocarditis is the most severe cardiovascular manifestation of irAEs, with an estimated incidence of 1% to 2%.

A large team of international medical scientists led by those at the University of Michigan (Ann Arbor, MI, USA) conducted an observational cohort study of all adult (≥18 years of age) patients who had received treatment with single or dual ICI at Michigan Medicine between June 2014 and December 2021. Serial testing for aspartate aminotransferase (AST) and alanine aminotransferase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase during ICI therapy was carried out on a weekly basis in all patients receiving ICI at Michigan Medicine for the duration of ICI therapy.

A total of 2,606 adult patients (mean age 64 ± 13 years; 60.7% men) received at least one dose of ICI between June 2014 and December 2021. Of these patients, 27 (1.0%) or 0.14 (95% CI: 0.09-0.21) cases per 10,000 person-years had a diagnosis of myocarditis attributed to ICI therapy, of which five cases were classified as definite, four as probable, and 18 as possible. The overall number of patients who received ICI therapy and the incidence of ICI myocarditis increased steadily each year from 2014 to 2021.

The team reported that at diagnosis, patients with myocarditis had an elevated high-sensitivity troponin T (100%), ALT (88.9%), AST (85.2%), CPK (88.9%), and lactate dehydrogenase (92.6%). Findings were confirmed in an independent cohort of 30 patients with biopsy-confirmed ICI myocarditis. A total of 95% of patients with ICI myocarditis had elevations in at least three biomarkers compared with 5% of patients without myocarditis. Among the non-cardiac biomarkers, only CPK was associated (per 100% increase) with the development of myocarditis (HR: 1.83) and all-cause mortality (HR: 1.10) in multivariable analysis. Elevations in CPK had a sensitivity of 99% and specificity of 23% for identifying myocarditis.

The authors concluded that although its incidence is rare, ICI myocarditis is associated with poor outcomes. Thus, identifying patients with myocarditis is crucial to provide early intervention and treatment. Acute ICI myocarditis co-occurs with other irAEs. Thus, evidence of possible irAEs such as elevated AST, ALT, and CPK during the first three months of ICI therapy should prompt further evaluation for ICI myocarditis, and normal levels of these biomarkers could rule out clinically significant acute ICI myocarditis. The study was published on December 20, 2022 in the journal JACC: CardioOncology.

Related Links:
University of Michigan

Flocked Swab
HydraFlock and PurFlock Ultra
Gold Supplier
PCR Microplate
ALLERgen Specific IgE ELISA Kits
Semi-Automatic Coagulation Analyzer
Clot 2B

Print article



view channel
Image: The Atellica HEMA 570 and 580 hematology analyzers remove workflow barriers (Photo courtesy of Siemens)

Next-Gen Hematology Analyzers Eliminate Workflow Roadblocks and Achieve Fast Throughput

Hematology testing is a critical aspect of patient care, utilized to establish a patient's health baseline, track treatment progress, or guide timely modifications to care. However, increasing constraints... Read more


view channel
Image: Newly observed anti-FSP antibodies have also been found to predict immune-related adverse events (Photo courtesy of Calviri)

First Blood-Based Biomarkers Test to Predict Treatment Response in Cancer Patients

Every year worldwide, lung cancer afflicts over two million individuals and almost the same number of people succumb to the disease. This malignancy leads the charts in cancer-related mortalities, with... Read more


view channel
Image: The rapid MTB strip test for tuberculosis can identify TB patients within two hours (Photo courtesy of Chulalongkorn University)

Rapid MTB Strip Test Detects Tuberculosis in Less Than an Hour without Special Tools

Tuberculosis (TB), a highly infectious disease, continues to pose significant challenges to public health worldwide. TB is caused by a bacterium known as "Mycobacterium tuberculosis," spreading through... Read more


view channel
Image: The UNIQO 160 (CE-IVDR) advances diagnostic analysis for autoimmune diseases (Photo courtesy of EUROIMMUN)

Novel Automated IIFT System Enables Cutting-Edge Diagnostic Analysis

A newly-launched automated indirect immunofluorescence test (IIFT) system for autoimmune disease diagnostics offers an all-in-one solution to enhance the efficiency of the complete IIFT process, comprising... Read more


view channel
Electronic biosensor uses DNA aptamers for detecting biomarkers in whole blood samples (Photo courtesy of Freepik)

Electronic Biosensor Detects Biomarkers in Whole Blood Samples without Addition of Reagents

The absence of robust, reliable, and user-friendly bioanalytical tools for early and timely diagnosis of cardiovascular diseases, particularly sudden cardiac arrest, leads to preventable deaths and imposes... Read more


view channel
Image: The global HbA1c testing devices market is expected to reach USD 2.56 billion in 2027 (Photo courtesy of Freepik)

Global Hemoglobin A1c Testing Devices Market Driven by Rising Prevalence of Diabetes

Hemoglobin A1c (HbA1c), or glycated hemoglobin, refers to hemoglobin with glucose attached. HbA1c testing devices are used for blood tests that determine average blood glucose, or blood sugar levels.... Read more
Copyright © 2000-2023 Globetech Media. All rights reserved.