ECG Changes in Melanoma Patients Undergoing Cancer Therapy-Data From the ECoR Registry

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Immune checkpoint inhibitors (ICI) are increasingly used for advanced melanoma.
• Potential cardiac side effects of ICI therapy require thorough investigation.
• Electrocardiogram (ECG) parameters may reveal subclinical cardiac changes during treatment.

Purpose of the Study:

• To evaluate changes in ECG parameters in melanoma patients treated with ICI.
• To assess the impact of ICI therapy on heart rate, PR interval, QRS duration, QTc, and QT dispersion (QTd).
• To identify specific ICI regimens associated with ECG alterations.

Main Methods:

• Retrospective analysis of 41 advanced melanoma patients from the Essen Cardio-oncology Registry (ECoR).
• ECGs were recorded before and 4-12 weeks after initiating ICI therapy.
• Analysis included heart rate, PR time, QRS duration, QTc interval, and calculated QT dispersion (QTd).

Main Results:

• No significant changes were observed in heart rate, PR time, QRS duration, or QTc interval.
• QT dispersion (QTd) significantly prolonged after ICI therapy initiation (32 ± 16 ms vs. 47 ± 19 ms, p < 0.0001).
• Combination immunotherapy (ipilimumab and nivolumab) led to significant QTd prolongation (31 ± 14 ms vs. 50 ± 14 ms, p < 0.0001), unlike PD-1 inhibitor monotherapy.

Conclusions:

• ICI therapy, especially combination regimens, can lead to QT dispersion prolongation in melanoma patients.
• Prolonged QTd may indicate an increased susceptibility to ventricular arrhythmias.
• Further research is warranted to understand the clinical implications of ICI-induced ECG changes.