Evidence map›Paper›PMID 42291359›Full record

ArticleTranslational lung cancer research2026

Development and external validation of a multivariable nomogram for predicting severe immune checkpoint inhibitor-associated myocarditis in advanced lung cancer.

Tao Luan, Kangjing Ma, Shuaiying Wang, Qingqing Yang, Hongbin Ma, Wei Liu, Junyi Mo, Can Huang, Jiawen Chen, Xinqing Lin and 19 more

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Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
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2citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

29 authors.

Tao Luan *Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Kangjing Ma *Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Shuaiying Wang *Anesthesia Surgery Center, Zhejiang Cancer Hospital, Hangzhou, China.
Qingqing YangDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Hongbin MaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Wei LiuDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Junyi MoDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Can HuangDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Jiawen ChenDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Xinqing LinDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Zekun ChenliDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Zijun RongDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Baodan YuDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Shanshan LiDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Yang LuanFaculty of Life Science and Technology, Kunming University of Science and Technology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Qun LvDepartment of Respiratory Medicine, Hangzhou Second People's Hospital, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Hanxiu LuFaculty of Life Science and Technology, Kunming University of Science and Technology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Gang YangFaculty of Life Science and Technology, Kunming University of Science and Technology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Yunhui ZhangFaculty of Life Science and Technology, Kunming University of Science and Technology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Leyang YaoDepartment of Respiratory Medicine, Jiexi County Second People's Hospital, Jieyang, China.
Yijie FangDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Xinfei HeDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Zhenyi LinDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Panxiao ShenDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Suneng FuDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Xiaowu TanDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Xiaohong XieDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Limin WangDepartment of Pulmonary and Critical Care Medicine, Affiliated Hangzhou First People Hospital, School of Medicine, Westlake University, Hangzhou, China.
Chengzhi ZhouDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune checkpoint inhibitors (ICIs) have improved outcomes in advanced lung cancer, but immune checkpoint inhibitor-associated myocarditis (ICIM), particularly severe ICIM, remains a rare yet potentially fulminant and fatal immune-related adverse event (irAE). We aimed to develop and externally validate a clinically accessible risk-prediction model based on routine baseline cardiac assessments to enable early identification and risk stratification of patients at high risk of severe ICIM around ICI initiation. Methods: This multicenter retrospective study included a training set, an internal validation set, and an external validation set. Patients with early-stage lung cancer, no ICI exposure, incomplete baseline cardiac evaluation [electrocardiogram (ECG)/echocardiography], missing predictor data, or insufficient follow-up were excluded; pre-existing cardiovascular comorbidities were not exclusionary and were recorded as baseline characteristics. The primary endpoint was severe ICIM [Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade ≥3]. Candidate predictors [high-sensitivity troponin, B-type natriuretic peptide (BNP), ECG, and echocardiography] were obtained from baseline/routine assessments at ICI initiation, prior to any ICIM event. Model Discrimination was assessed using receiver operating characteristic curve/area under the curve (ROC/AUC) with calibration plots and decision curve analysis (DCA) evaluating calibration and clinical utility. Results: A total of 834 patients were enrolled, with an overall mean age of 60 years [standard deviation (SD) =14]; by cohort, mean ages were approximately 59 years (training set), 61 years (internal validation set), and 61 (external validation set) years. Males accounted for 79.5% of the total cohort, with a slightly higher proportion in the internal validation set (83.2%) compared to the training (75.5%) and external validation (81.4%) sets. The prevalence of smoking was 61.0% and comparable across cohorts; 52.3% had comorbidities. Adenocarcinoma was the most common subtype (39.8%), followed by squamous cell carcinoma (35.4%), with similar distributions across cohorts. Based on these cohorts, four readily available predictors (troponin, BNP, ECG, echocardiography) were retained to construct the severe ICIM model and nomogram. The AUCs were 0.926 [95% confidence interval (CI): 0.880-0.971] in the training set, 0.885 (95% CI: 0.742-1.000) in the internal validation set, and 0.949 (95% CI: 0.884-1.000) in the external validation set; calibration plots and DCA demonstrated favorable agreement between predicted and actual outcomes, as well as significant net benefit across clinically relevant thresholds. Conclusions: This four-predictor severe ICIM risk model and nomogram, developed from multicenter real-world data and externally validated, supports early risk stratification and monitoring strategies for advanced lung cancer patients receiving ICIs. Prospective studies are warranted to confirm its generalizability and optimize implementation.

Indexed as

immunotherapy-induced myocarditisLung cancerrisk-scoring model

Identifiers

PMID42291359
PMCPMC13263832

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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.