Characterisation of inflammatory atheroma due to ICI and VEGFi
Research type
Research Study
Full title
Biomarker and Imaging Characterisation of Inflammatory Atheroma in Patients Receiving Immunotherapy and Angiogenesis Inhibitors: A Prospective Study in Patients with Cancer (BioCAPRI)
IRAS ID
304272
Contact name
Ninian Lang
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Summary of Research
The advent of immunotherapy (immune checkpoint inhibitors [ICI]) has been an extremely important advancement for cancer treatment in recent decades. The anti-cancer effects of these agents is profound and can lead to radiological 'disappearance' of the primary cancer and metastatic deposits. ICI are now commonly used in the treatment of multiple cancers including melanoma, kidney cancer, liver cancer and lung cancer. ICI can be used on their own or in combination with other agents such as vascular endothelial growth factor inhibitors (VEGFi) which is first line treatment for many patients. However, it has become clear that these drugs have cardiovascular side effects including high blood pressure and a reduction in the heart muscle pumping function. It is also increasingly recognised that ICIs may have a toxic effect on blood vessels resulting in an increased risk of heart attack or stroke. These side effects can have a significant impact on patients' health and can lead to withdrawal of important cancer treatment. The mechanisms by which these side effects occur are unclear and have not been well described to date.
The aim of this study is to examine the effect of ICI and VEGFi, both alone and in combination, on blood vessels and to understand their effects on blood markers and heart function. This study is observational and will not require any modification of cancer therapy.
This study will aim to recruit patients diagnosed with cancer who are already planned to receive ICI or VEGFi alone or in combination at the Beatson West of Scotland Oncology Centre. Patients will undergo a vascular PET-CT scan before and 6 months after starting treatment. In addition patients will undergo echocardiography and tests of the function of the small blood vessels in the fingertips with a special machine (EndoPat). Blood and urine samples will also be collected.
Summary of Results
We wished to see if modern cancer drugs, immune checkpoint inhibitors and VEGFi were associated with inflammation in the arteries which could cause heart attacks.
We assessed inflammation in the arteries by using a special scanner called a PET scan which looks at activity in the arteries.
We observed no evidence that there was inflammation in the arteries after starting these drugs compared to before they started.REC name
West of Scotland REC 5
REC reference
22/WS/0085
Date of REC Opinion
5 Jul 2022
REC opinion
Further Information Favourable Opinion