Evidence map›Paper›PMID 40547024›Full record

SynthesisFrontiers in immunology2025

Effect of immune checkpoint inhibitor therapy on biventricular mechanics in cancer patients over a short-term follow-up: a systematic review.

Andrea Sonaglioni, Antonino Bruno, Gian Luigi Nicolosi, Emanuela Fossile, Cristian Rubuano, Riccardo Ricotta, Maria Gemelli, Michele Lombardo, Paola Muti, Barbara Bassani

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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.

Andrea SonaglioniDivision of Cardiology, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Antonino BrunoLaboratory of Innate Immunity, Unit of Molecular Pathology, Biochemistry and Immunology, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Gian Luigi NicolosiDivision of Cardiology, Policlinico San Giorgio, Pordenone, Italy.
Emanuela FossileDivision of Oncology, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Cristian RubuanoLaboratory of Innate Immunity, Unit of Molecular Pathology, Biochemistry and Immunology, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Riccardo RicottaMedical Oncology Unit, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Maria GemelliMedical Oncology Unit, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Michele LombardoDivision of Cardiology, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.
Paola MutiIstituto di ricovero e cura a carattere scientifico (IRCCS), MultiMedica, Milan, Italy.
Barbara BassaniLaboratory of Innate Immunity, Unit of Molecular Pathology, Biochemistry and Immunology, Istituto di ricovero e cura a carattere scientifico (IRCCS) MultiMedica, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune checkpoint inhibitors (ICI) have demonstrated a survival benefit in various cancer types. A few numbers of imaging studies have recently measured myocardial strain parameters in cancer patients before and after ICI treatment, reporting not univocal results. This systematic review has been primarily designed to summarize the main findings of these studies and to examine the overall effect of ICI therapy on biventricular mechanics in cancer patients. Methods: All imaging studies evaluating the effect of ICI therapy on biventricular mechanics in cancer patients, selected from PubMed and EMBASE databases, were included. Imaging studies that analyzed myocardial strain parameters in highly selected cancer patients with ICI-related myocarditis were excluded. Relative change (RC) (%) from baseline of conventional and innovative indices of biventricular function was determined. Prevalence of cardiovascular complications was also assessed. Results: The full-texts of 12 studies with 554 ICI-treated cancer patients were analyzed. Myocardial strain parameters were measured by two-dimensional-speckle tracking echocardiography (STE) in seven studies, three-dimensional STE in two studies and cardiac magnetic resonance feature tracking in the remaining three studies. Average duration of follow-up was 3.1 months (range 0.5-7.3 months). All conventional indices of biventricular mechanics showed small and not statistically significant change after ICI treatment (RC ranging between -6.9 and +4.8%). Conversely, average left ventricular (LV)-global longitudinal strain (GLS), LV-global circumferential strain, LV-global radial strain, left atrial reservoir strain, right ventricular (RV)-GLS, RV-free wall longitudinal strain and right atrial reservoir strain were significantly worsened after ICI treatment (RC ranging between -9 and -19.2%). A definite cancer therapy-related cardiac dysfunction (CTRCD) was detected in 28.3% of ICI-treated patients (range 19.4-38.1%). The pooled prevalence of acute ICI-related myocarditis was 0.8% (range 0-4.6%) over follow-up period. Three out of seven ICI-related myocarditis patients (42.8%) were diagnosed with fulminant acute myocarditis. Conclusions: ICI treatment causes a significant deterioration of biventricular mechanics, early diagnosed by strain imaging methods. Myocardial strain parameters are more sensitive than conventional indices of systolic function for the early detection of subclinical ICI-related cardiotoxicity. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier INPLASY202490131.

Indexed as

Immune Checkpoint InhibitorsNeoplasmsEchocardiographyFollow-Up StudiesHumansImmune Checkpoint Inhibitorsbiventricular mechanicscardiotoxicityimmune checkpoint inhibitor therapymyocarditissubclinical myocardial dysfunction

Identifiers

PMID40547024
PMCPMC12179113

What OpenQuestion holds

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Registered trials

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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.