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Master Thesis

Étude prospective visant à détecter la myocardite immunoinduite chez les patients traités pour un cancer du poumon

Abstract : Introduction: immune checkpoint inhibitors are widely used in lung cancer management. However, myocarditis which is a rare, yet potentially severe adverse related event associated with ICIs, could be underreported. The study aimed to prospectively evaluate the incidence of subclinical myocarditis, through systematic screening, among patients receiving ICIs for lung cancer. Methods: all patients receiving a first administration of ICIs for non-small and small lung cancer, between May and November 2020, in the pulmonary department of Bordeaux University Hospital, were included and had a 6 month follow up. ECG, troponin, and natriuretic peptide dosages before ICIs' first administration and before each infusion were recorded. Echocardiography, magnetic resonance imaging, coronarography and endomyocardial biopsy were done additionally, in case of increased troponin levels, modifications in ECG and onset of cardiovascular symptoms. The primary outcome was defined as ICIs related myocarditis onset, while secondary outcomes included other cardiovascular events, disease-free and overall survival. Results: ninety-Nine patients received their 1st infusion of ICIs for lung cancer (mean age 64 ± 9 years; 52% men, 67% with adenocarcinoma). Three cases of subclinical myocarditis without major adverse cardiac event occurred (2 definite and 1 possible), and the mean duration between 1st ICIs’ administration and myocarditis onset was 144 ±3 days. Median disease-free survival and overall survival were 169 [102; 233] days and 209 [147; 249] days respectively. Conclusion: in our study, subclinical myocarditis associated with ICIs occurred more frequently and had a later onset than previously reported. Practitioners should incorporate early myocarditis screening when treating lung cancer patients with ICIs.
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https://dumas.ccsd.cnrs.fr/dumas-03388705
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Submitted on : Wednesday, October 20, 2021 - 3:37:57 PM
Last modification on : Thursday, November 25, 2021 - 3:15:46 AM
Long-term archiving on: : Friday, January 21, 2022 - 8:13:10 PM

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  • HAL Id : dumas-03388705, version 1

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Clara Faubry. Étude prospective visant à détecter la myocardite immunoinduite chez les patients traités pour un cancer du poumon. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03388705⟩

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