PhD Scientific Days 2026

Cardiovascular Medicine and Research 2.

Cardiovascular Side Effects of Immune Checkpoint Inhibitor Oncological Therapies and Their Monitoring in the Context of Onco-Cardiology

Name of the presenter

Sándor, Zsófia

Institute/workplace of the presenter

Semmelweis University, Városmajor Heart and Vascular Center and Semmelweis University, Internal Medicine and Hematology Clinic

Authors

Zsófia Sándor^1,2, Jaekyung Lee¹, Metasebia Amha¹, Dániel Maráczi MD¹, Tamás Koleszár¹, Prof. Péter Holló MD, PhD³, Prof. Veronika Müller MD, PhD⁴, Prof. Béla Merkely MD, PhD², Zoltán Pozsonyi MD, PhD¹, Zsófia Drobni MD, PhD¹
1: Semmelweis University, Városmajor Heart and Vascular Center
2: Semmelweis University, Internal Medicine and Hematology Clinic
3: Semmelweis University, Dermatology, Venereology and Dermato-Oncology Clinic
4: Semmelweis University, Pulmonology Clinic

Text of the abstract

Introduction
Immune checkpoint inhibitors (ICIs) represent one of the most widely used modern oncologic immunotherapies, with an expanding range of indications both worldwide and in Hungary. Although these agents have revolutionized cancer care, their use has been associated with an increased risk of major adverse cardiovascular events (MACEs). Several studies have reported elevated risk during ICI therapy, however, no Hungarian data have yet been published regarding their incidence and risk profile.
Aims
The aim of our study was to evaluate the real-world implementation of baseline cardiovascular assessment in patients receiving ICI therapy and to characterize the incidence and risk profile of MACEs.
Methods
In our retrospective clinical study, we analyzed data from patients treated at the clinics of Semmelweis University who received at least one dose of ICI therapy in 2023. Comorbidities were assessed using the Charlson Comorbidity Index (CCI), with cardiovascular risk stratified according to the European Society of Cardiology (ESC) model and the risk of venous thromboembolic events (VTEs) estimated using the Khorana score. Univariable predictors of MACEs were identified and entered into multivariable models with clinically relevant covariates. Guideline adherence was evaluated using a quality-of-care analysis.
Results
A total of 589 patients were evaluated in the study. The median age was 67 years. During a median follow-up of 748 days (IQR 402-1221 days), 203 MACEs and 449 immune-related adverse events occurred, and 278 patients (47.2%) died.
Most MACEs developed during the first four cycles of ICI therapy. The most common were VTEs (44, 21.7%). The majority of patients were at high cardiovascular risk (ESC 79.5%), however, guideline-recommended baseline cardiovascular assessment was documented in only 0.34% of the overall cohort.
Conclusions
The majority of patients receiving ICI therapy are at high cardiovascular risk, however, baseline cardiovascular assessment frequently falls short of guideline recommendations. MACEs are common, particularly in the early phase of therapy, and are well predicted by comorbidity burden and high ESC risk status. Our findings underscore the importance of guideline-based baseline assessment and early cardiovascular monitoring.