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Sodium-glucose co-transporter-2 inhibitors in patients treated with immune checkpoint inhibitors

Moran Gvili Perelman1,2, Rafael Y Brzezinski1,2, Barliz Waissengrin3,2

  • 1Division of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.

Cardio-Oncology (London, England)
|January 11, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) significantly reduced all-cause mortality in cancer patients with type 2 diabetes receiving immune checkpoint inhibitors (ICIs). SGLT2i may also offer benefits against cardiotoxicity in this population.

Area of Science:

  • Oncology
  • Cardiology
  • Endocrinology

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer treatment.
  • Diabetes mellitus (DM) negatively impacts outcomes for patients on ICIs.
  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve cardiovascular outcomes and reduce mortality in diabetic patients.

Purpose of the Study:

  • To assess the prognostic impact of SGLT2i on all-cause mortality.
  • To evaluate the effect of SGLT2i on cardiotoxicity in cancer patients treated with ICIs.

Main Methods:

  • Retrospective analysis of cancer patients with type 2 DM (DM2) treated with ICIs.
  • Comparison of outcomes between patients treated with and without SGLT2i.
  • Primary endpoint: all-cause mortality. Secondary endpoint: Major Adverse Cardiovascular Events (MACE).

Main Results:

  • The SGLT2i group (24 patients) showed significantly lower all-cause mortality (21% vs. 59%, p=0.002) compared to the non-SGLT2i group (95 patients) over 28 months.
  • No significant difference in MACE was observed.
  • Zero cases of myocarditis and atrial fibrillation occurred in the SGLT2i group versus 2 and 6 cases, respectively, in the non-SGLT2i group.

Conclusions:

  • SGLT2i therapy is associated with reduced all-cause mortality in cancer patients with DM2 undergoing ICI treatment.
  • Further research is warranted to elucidate the mechanisms and confirm the cardiotoxicity benefits of SGLT2i in this context.
Keywords:
Cardio-oncologyCardiotoxicityDiabetesICIsImmune checkpoint inhibitorSGLT2

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