Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis
Abstract Purpose Immune checkpoint inhibitors-related myocarditis (ICI-M) is one of the immune-related adverse events (irAEs), which is rare and highly lethal. This study aimed to establish nomograms based on ratio biomarkers to predict the severity and prognosis of ICI-M. Methods We retrospectively...
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Springer
2024-05-01
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| Series: | Journal of Cancer Research and Clinical Oncology |
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| Online Access: | https://doi.org/10.1007/s00432-024-05801-7 |
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| author | Zhenli Li Tiezhu Yao Guang Liu Zhengkun Guan Jing Liu Ling Guo Jingtao Ma |
| author_facet | Zhenli Li Tiezhu Yao Guang Liu Zhengkun Guan Jing Liu Ling Guo Jingtao Ma |
| author_sort | Zhenli Li |
| collection | DOAJ |
| description | Abstract Purpose Immune checkpoint inhibitors-related myocarditis (ICI-M) is one of the immune-related adverse events (irAEs), which is rare and highly lethal. This study aimed to establish nomograms based on ratio biomarkers to predict the severity and prognosis of ICI-M. Methods We retrospectively examined patients with advanced cancers who were also diagnosed with ICI-M at the Fourth Hospital of Hebei Medical University. The patients of ICI-M were divided into mild and severe groups and a 40-day following up was carried out. The major adverse cardiovascular events(MACEs) were regarded as the endpoint. Nomogram-based models were established and validated. Results Seventy-seven patients were involved, including 31 severe cases(40.3%). Lactate dehydrogenase-to-albumin ratio(LAR) combined with the change rate from baseline to onset of LAR( $$\triangle$$ ▵ LAR) which performed best to diagnose the severe ICI-M was identified to establish the nomogram-based model. The bootstrap-corrected concordance index [0.752 95% confidence interval (CI): 0.635 $$-$$ - 0.866] and calibration plot with good degree of fitting confirmed this diagnostic model. Neutrophil-to-high-density lipoprotein cholesterol ratio(NHR) and LAR were also screened into the nomogram-based model for 40-day MACEs after ICI-M, which performed well by validating for concordance index(0.779 95% CI: 0.677 $$-$$ - 0.865)and calibration plots after being bootstrap-corrected. Moreover, a $$\ge$$ ≥ 101% increase in LAR significantly separated patients in MACE-free survival. Conclusion Ratio indexes at onset and their change rates from baseline showed good diagnostic value for the severity of ICI-M and prognostic value for subsequent MACEs, particularly LAR, NHR and their change rates. The nomogram-based models of ratio indexes could provide a potential choice for early detection and monitor of the severe ICI-M and subsequent MACEs. Graphical abstract |
| format | Article |
| id | doaj-art-09dad72c1d374bf1b751a16f8cb7342a |
| institution | Kabale University |
| issn | 1432-1335 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Cancer Research and Clinical Oncology |
| spelling | doaj-art-09dad72c1d374bf1b751a16f8cb7342a2025-02-09T12:10:02ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352024-05-01150511410.1007/s00432-024-05801-7Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysisZhenli Li0Tiezhu Yao1Guang Liu2Zhengkun Guan3Jing Liu4Ling Guo5Jingtao Ma6Department of Cardiology, The Fourth Hospital of Hebei Medical UniversityDepartment of Cardiology, The Fourth Hospital of Hebei Medical UniversityDepartment of Cardiology, The Fourth Hospital of Hebei Medical UniversityDepartment of Cardiology, The Fourth Hospital of Hebei Medical UniversityDepartment of Cardiology, The Fourth Hospital of Hebei Medical UniversityDepartment of Cardiology, The Fourth Hospital of Hebei Medical UniversityDepartment of Cardiology, The Fourth Hospital of Hebei Medical UniversityAbstract Purpose Immune checkpoint inhibitors-related myocarditis (ICI-M) is one of the immune-related adverse events (irAEs), which is rare and highly lethal. This study aimed to establish nomograms based on ratio biomarkers to predict the severity and prognosis of ICI-M. Methods We retrospectively examined patients with advanced cancers who were also diagnosed with ICI-M at the Fourth Hospital of Hebei Medical University. The patients of ICI-M were divided into mild and severe groups and a 40-day following up was carried out. The major adverse cardiovascular events(MACEs) were regarded as the endpoint. Nomogram-based models were established and validated. Results Seventy-seven patients were involved, including 31 severe cases(40.3%). Lactate dehydrogenase-to-albumin ratio(LAR) combined with the change rate from baseline to onset of LAR( $$\triangle$$ ▵ LAR) which performed best to diagnose the severe ICI-M was identified to establish the nomogram-based model. The bootstrap-corrected concordance index [0.752 95% confidence interval (CI): 0.635 $$-$$ - 0.866] and calibration plot with good degree of fitting confirmed this diagnostic model. Neutrophil-to-high-density lipoprotein cholesterol ratio(NHR) and LAR were also screened into the nomogram-based model for 40-day MACEs after ICI-M, which performed well by validating for concordance index(0.779 95% CI: 0.677 $$-$$ - 0.865)and calibration plots after being bootstrap-corrected. Moreover, a $$\ge$$ ≥ 101% increase in LAR significantly separated patients in MACE-free survival. Conclusion Ratio indexes at onset and their change rates from baseline showed good diagnostic value for the severity of ICI-M and prognostic value for subsequent MACEs, particularly LAR, NHR and their change rates. The nomogram-based models of ratio indexes could provide a potential choice for early detection and monitor of the severe ICI-M and subsequent MACEs. Graphical abstracthttps://doi.org/10.1007/s00432-024-05801-7ICI-associated myocarditisMACEPredictive modelPrognostic analysisDiagnostic analysisNomogram |
| spellingShingle | Zhenli Li Tiezhu Yao Guang Liu Zhengkun Guan Jing Liu Ling Guo Jingtao Ma Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis Journal of Cancer Research and Clinical Oncology ICI-associated myocarditis MACE Predictive model Prognostic analysis Diagnostic analysis Nomogram |
| title | Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis |
| title_full | Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis |
| title_fullStr | Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis |
| title_full_unstemmed | Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis |
| title_short | Nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors-related myocarditis: a retrospective analysis |
| title_sort | nomograms based on ratio indexes to predict severity and prognosis in immune checkpoint inhibitors related myocarditis a retrospective analysis |
| topic | ICI-associated myocarditis MACE Predictive model Prognostic analysis Diagnostic analysis Nomogram |
| url | https://doi.org/10.1007/s00432-024-05801-7 |
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