PET, Proteomics, and Immunophenotyping of Arterial Inflammation and Checkpoint Inhibition

Are immune checkpoint inhibitors (ICIs), alone or in combination with vascular endothelial growth factor inhibitors (VEGFIs), associated with increased arterial inflammation in patients with cancer? In this cohort study of 55 patients evaluated before and 24 weeks after starting therapy, (¹⁸F)fluorodeoxyglucose positron emission tomography/computed tomography showed no increase in arterial inflammation among patients treated with ICIs, VEGFIs, or their combination. Spectral flow cytometry, plasma proteomics, and inflammatory biomarkers showed only selective, low-magnitude immune changes. These findings suggest that if ICIs and VEGFIs therapies confer atherothrombotic risk, the mechanism is unlikely to be macrophage-driven arterial inflammation; alternative endothelial and thrombotic pathways warrant prioritization for future research.

Corresponding Author: Ninian N. Lang, MBChB, PhD, BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Ave, Glasgow G12 8TA, United Kingdom (ninian.lang@glasgow.ac.uk).

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