Evidence map›Paper›PMID 38364453›Full record

ArticleESMO open2024

Clinical presentation of cardiac symptoms following treatment with tumor-infiltrating lymphocytes: diagnostic challenges and lessons learned.

J S W Borgers, A W van Schijndel, J V van Thienen, S Klobuch, T T P Seijkens, R P Tobin, L van Heerebeek, A Driessen-Waaijer, M W Rohaan, J B A G Haanen

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Article in ESMO open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 3 countries.

J S W BorgersDepartment of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam.
A W van SchijndelDepartment of Intensive Care, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Cardiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam.
J V van ThienenDepartment of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam.
S KlobuchDepartment of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam.
T T P SeijkensDepartment of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Biochemistry, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
R P TobinDepartment of Surgery, Division of Surgical Oncology, University of Colorado Anschutz Medical Campus, Aurora, USA.
L van HeerebeekDepartment of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam.
A Driessen-WaaijerDepartment of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam.
M W RohaanDepartment of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam.
J B A G HaanenDepartment of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands; Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: j.haanen@nki.nl.
The Netherlands Cancer Institute · NLOLVG · NLLeiden University Medical Center · NLUniversity of Colorado Anschutz Medical Campus · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment with tumor-infiltrating lymphocytes (TILs) is rapidly evolving for patients with solid tumors. Following metastasectomy, TILs (autologous, intratumoral CD4+ and CD8+ T cells with the potential to recognize tumor-associated antigens) are isolated and non-specifically expanded ex vivo in the presence of interleukin-2 (IL-2). Subsequently, the TILs are adoptively transferred to the patients after a preconditioning non-myeloablative, lymphodepleting chemotherapy regimen, followed by administration of high-dose (HD) IL-2. Here, we provide an overview of known cardiac risks associated with TIL treatment and report on seven patients presenting with cardiac symptoms, all with different clinical course and diagnostic findings during treatment with lymphodepleting chemotherapy, TIL, and HD IL-2, and propose a set of clinical recommendations for diagnosis and management of these symptoms. PATIENTS AND

methodsThis single-center, retrospective study included selected patients who experienced TIL treatment-related cardiac symptoms at the Netherlands Cancer Institute. In addition, 12 patients were included who received TIL in the clinical trial setting without experiencing cardiac symptoms, from whom complete cardiac biomarker follow-up during treatment was available [creatine kinase (CK), CK-myocardial band, troponin T and N-terminal pro-B-type natriuretic peptide].

resultsWithin our TIL patient population, seven illustrative cases were chosen from the patients who developed symptoms suspected of severe cardiotoxicity: myocarditis, myocardial infarction, peri-myocarditis, atrial fibrillation, acute dyspnea, and two cases of heart failure. An overview of their clinical course, diagnostics carried out, and management of the symptoms is provided.

conclusionsIn the absence of evidence-based guidelines for the treatment of TIL therapy-associated cardiotoxicity, we provided an overview of literature, case descriptions, and recommendations for diagnosis and management to help physicians in daily practice, as the number of patients qualifying for TIL treatment is rapidly increasing.

Indexed as

Lymphocytes, Tumor-InfiltratingMyocarditisDisease ProgressionHumansInterleukin-2Retrospective StudiesInterleukin-2cardiotoxicityguidelinesinterleukin-2melanomanon-small-cell lung cancertumor-infiltrating lymphocytes

Identifiers

PMID38364453
PMCPMC10937195
OpenAlexW4391850932

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.