Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study
Abstract Immune checkpoint inhibitor (ICI) therapies effectively treat a broadening spectrum of cancer entities but induce various immune-related side effects (irAEs). Recent reports suggest a correlation between ICI-induced systemic inflammation and thromboembolic events as well as an increased eff...
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| Format: | Article |
| Language: | English |
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Springer
2024-11-01
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| Series: | Cancer Immunology, Immunotherapy |
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| Online Access: | https://doi.org/10.1007/s00262-024-03850-y |
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| author | Malte Beckmann Julian Schlüter Michael Erdmann Rafaela Kramer Sarah Cunningham Holger Hackstein Robert Zimmermann Lucie Heinzerling |
| author_facet | Malte Beckmann Julian Schlüter Michael Erdmann Rafaela Kramer Sarah Cunningham Holger Hackstein Robert Zimmermann Lucie Heinzerling |
| author_sort | Malte Beckmann |
| collection | DOAJ |
| description | Abstract Immune checkpoint inhibitor (ICI) therapies effectively treat a broadening spectrum of cancer entities but induce various immune-related side effects (irAEs). Recent reports suggest a correlation between ICI-induced systemic inflammation and thromboembolic events as well as an increased effectiveness by coadministration of anticoagulants. With cancer patients having a higher risk of thrombotic events per se, it is crucial to dissect and characterize the mechanisms that cause pro-coagulative effects induced by systemic tumor therapies and their potential interplay with anti-tumor response. A total of 31 patients with advanced skin cancer treated with either ICIs (n = 24) or BRAF/MEK inhibitors (n = 7) were longitudinally assessed for blood and coagulation parameters before as well as 7, 20 and 40 days after initiation of systemic tumor therapy. Changes were analyzed and compared between both groups. In addition, the influence of coagulation parameters on progression-free, recurrence-free and overall survival was investigated. The ICI cohort presented significantly increased factor VIII activity after one week of therapy (p 0.0225); while, protein S activity was reduced during the whole observation period. Additionally, von Willebrand factor activity and tissue factor concentrations increased under immunotherapy. Similar changes occurred under BRAF/MEK inhibitor therapy (BRAF/MEKi). Increased baseline levels of von Willebrand factor antigen and factor VIII:C before the start of ICI therapy correlated with a significantly higher risk of recurrence for patients receiving adjuvant immunotherapy. The findings suggest the induction of a pro-coagulant state under ICI and BRAF/MEKi and a role of coagulation parameters in the efficacy of ICI therapies. |
| format | Article |
| id | doaj-art-ad84db8b06514630b429cac29d146368 |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Springer |
| record_format | Article |
| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-ad84db8b06514630b429cac29d1463682025-02-02T12:26:34ZengSpringerCancer Immunology, Immunotherapy1432-08512024-11-0174111110.1007/s00262-024-03850-yInterdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective studyMalte Beckmann0Julian Schlüter1Michael Erdmann2Rafaela Kramer3Sarah Cunningham4Holger Hackstein5Robert Zimmermann6Lucie Heinzerling7Department of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU)Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU)Department of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU)Department of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU)Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU)Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU)Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU)Department of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU)Abstract Immune checkpoint inhibitor (ICI) therapies effectively treat a broadening spectrum of cancer entities but induce various immune-related side effects (irAEs). Recent reports suggest a correlation between ICI-induced systemic inflammation and thromboembolic events as well as an increased effectiveness by coadministration of anticoagulants. With cancer patients having a higher risk of thrombotic events per se, it is crucial to dissect and characterize the mechanisms that cause pro-coagulative effects induced by systemic tumor therapies and their potential interplay with anti-tumor response. A total of 31 patients with advanced skin cancer treated with either ICIs (n = 24) or BRAF/MEK inhibitors (n = 7) were longitudinally assessed for blood and coagulation parameters before as well as 7, 20 and 40 days after initiation of systemic tumor therapy. Changes were analyzed and compared between both groups. In addition, the influence of coagulation parameters on progression-free, recurrence-free and overall survival was investigated. The ICI cohort presented significantly increased factor VIII activity after one week of therapy (p 0.0225); while, protein S activity was reduced during the whole observation period. Additionally, von Willebrand factor activity and tissue factor concentrations increased under immunotherapy. Similar changes occurred under BRAF/MEK inhibitor therapy (BRAF/MEKi). Increased baseline levels of von Willebrand factor antigen and factor VIII:C before the start of ICI therapy correlated with a significantly higher risk of recurrence for patients receiving adjuvant immunotherapy. The findings suggest the induction of a pro-coagulant state under ICI and BRAF/MEKi and a role of coagulation parameters in the efficacy of ICI therapies.https://doi.org/10.1007/s00262-024-03850-yImmune checkpoint inhibitorsBRAF/MEK inhibitorsMelanomaCoagulation–fibrinolysis disordersICI-associated thrombosisPredictive marker |
| spellingShingle | Malte Beckmann Julian Schlüter Michael Erdmann Rafaela Kramer Sarah Cunningham Holger Hackstein Robert Zimmermann Lucie Heinzerling Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study Cancer Immunology, Immunotherapy Immune checkpoint inhibitors BRAF/MEK inhibitors Melanoma Coagulation–fibrinolysis disorders ICI-associated thrombosis Predictive marker |
| title | Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study |
| title_full | Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study |
| title_fullStr | Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study |
| title_full_unstemmed | Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study |
| title_short | Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study |
| title_sort | interdependence of coagulation with immunotherapy and braf mek inhibitor therapy results from a prospective study |
| topic | Immune checkpoint inhibitors BRAF/MEK inhibitors Melanoma Coagulation–fibrinolysis disorders ICI-associated thrombosis Predictive marker |
| url | https://doi.org/10.1007/s00262-024-03850-y |
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