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Induction of Arterial Inflammation by Immune Checkpoint Inhibitor Therapy in Lung Cancer Patients as Measured by 2-[F]FDG Positron Emission Tomography/Computed Tomography Depends on Pre-Existing Vascular Inflammation

Title: Induction of Arterial Inflammation by Immune Checkpoint Inhibitor Therapy in Lung Cancer Patients as Measured by 2-[F]FDG Positron Emission Tomography/Computed Tomography Depends on Pre-Existing Vascular Inflammation
Authors: Calabretta, Raffaella; Beer, Lucian; Prosch, Helmut; Kifjak, Daria; Zisser, Lucia; Binder, Patrick; Grünert, Stefan; Langsteger, Werner; Li, Xiang; Hacker, Marcus
Contributors: Radiology
Publication Year: 2026
Collection: University of Massachusetts, Medical School: eScholarship@UMMS
Subject Terms: 2-[18F]FDG; PET; atherosclerosis; cardio-oncology; immune checkpoint inhibitors; lung cancer
Description: BACKGROUND: Immune checkpoint inhibitors (ICI) are one of the most effective therapies in oncology, albeit associated with various immune-related adverse events also affecting the cardiovascular system. METHODS: We aimed to investigate the effect of ICI on arterial 2-[F]FDG uptake by using 2-[F]FDG PET/CT imaging pre/post treatment in 47 patients with lung cancer. Maximum 2-[F]FDG standardized uptake values (SUVmax) and target-to-background ratios (TBRs) were calculated along six arterial segments. We classified the arterial PET lesions by pre-existing active inflammation (cut-off: TBRpre ≥ 1.6). 2-[F]FDG metabolic activity pre/post treatment was also quantified in bone marrow, spleen, and liver. Circulating blood biomarkers were additionally collected at baseline and after immunotherapy. RESULTS: ICI treatment resulted in significantly increased arterial inflammatory activity, detected by increased TBRs, in all arterial PET lesions analyzed. In particular, a significant elevation of arterial 2-[F]FDG uptake was only recorded in PET lesions without pre-existing inflammation, in calcified as well as in non-calcified lesions. Furthermore, a significant increase in arterial 2-[F]FDG metabolic activity after immunotherapy was solely observed in patients not previously treated with chemotherapy or radiotherapy as well as in those without CV risk factors. No significant changes were recorded in either 2-[F]FDG uptake of bone marrow, spleen and liver after treatment, or the blood biomarkers. CONCLUSIONS: ICI induces vascular inflammation in lung cancer patients lacking pre-existing arterial inflammation. ; No embargo
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
ISSN: 38276275
Relation: Life; https://doi.org/10.3390/life14010146; https://hdl.handle.net/20.500.14038/55127
DOI: 10.3390/life14010146
Availability: https://doi.org/10.3390/life14010146; https://hdl.handle.net/20.500.14038/55127
Rights: Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.942838DF
Database: BASE