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Updated: Sep 8, 2025

Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood
Published on: February 5, 2020
Effects of immune checkpoint inhibitors on the pulmonary circulation in lung cancer patients
Yao Xu1, Qiuhong Zhang1, Jie Gao1
1Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Abstract:
Immune checkpoint inhibitors (ICIs) are effective anti-tumor agents, but new immune-related side effects (irAEs) are emerging. This retrospective cohort study investigated 461 lung cancer patients treated with ICIs over 2 years, analyzing changes in pulmonary artery diameter (PAD), aortic diameter (AoD), and the pulmonary artery/aortic diameter (PAD/AoD) ratio through chest computed tomography (CT) at baseline, 3 months, 6 months, 1 year, and 2 years post-treatment. The PAD increased from 25.19 to 26.33 mm (p < .001) and the PAD/AoD ratio increased from 0.70 to 0.73 (p < .001) during ICI treatment over a 2-year follow-up period, as early as within the first 3 months. High-sensitivity troponin I (hs-TnI), α-hydroxybutyrate dehydrogenase (HBDH), creatine kinase (CK), creatine kinase MB (CK-MB), and coagulation indices exhibited significant changes (p < .05), while the cardiac ultrasound result remained unchanged. In subgroup analysis, the severe group demonstrated lower overall survival (OS) (43 months vs. 56 months) (p = .008) and progression-free survival (PFS) (15 months vs. 20 months, p < .001) compared to the non-severe group. Meanwhile, the severe PAD/AoD ratio progression served as independent predictors of prognosis in lung cancer patients receiving ICI treatment, but immune-related pneumonia(CIP) did not significantly influence the PAD/AoD ratio progression (p > .999). Therefore, in lung cancer patients receiving ICIs, pulmonary vascular involvement can occur within the initial 3 months and needs to be monitored with chest CT and echocardiography.
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