Evidence map›Paper›PMID 39487855›Full record

ArticleCancer immunology, immunotherapy : CII2024

Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study.

Malte Beckmann, Julian Schlüter, Michael Erdmann, Rafaela Kramer, Sarah Cunningham, Holger Hackstein, Robert Zimmermann, Lucie Heinzerling

Abstract read
In one paragraph

Article in Cancer immunology, immunotherapy : CII, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Malte BeckmannDepartment of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Julian SchlüterDepartment of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Michael ErdmannDepartment of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Rafaela KramerDepartment of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Sarah CunninghamDepartment of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Holger HacksteinDepartment of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Robert ZimmermannDepartment of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Lucie HeinzerlingDepartment of Dermatology, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), University Hospital Erlangen, Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany. Lucie.Heinzerling@med.uni-muenchen.de.

Funding

German Federal Ministry of Education and Research (BMBF) 01ZX1905A
6 · The paper itself

Abstract

Immune checkpoint inhibitor (ICI) therapies effectively treat a broadening spectrum of cancer entities but induce various immune-related side effects (irAEs). Recent reports suggest a correlation between ICI-induced systemic inflammation and thromboembolic events as well as an increased effectiveness by coadministration of anticoagulants. With cancer patients having a higher risk of thrombotic events per se, it is crucial to dissect and characterize the mechanisms that cause pro-coagulative effects induced by systemic tumor therapies and their potential interplay with anti-tumor response. A total of 31 patients with advanced skin cancer treated with either ICIs (n = 24) or BRAF/MEK inhibitors (n = 7) were longitudinally assessed for blood and coagulation parameters before as well as 7, 20 and 40 days after initiation of systemic tumor therapy. Changes were analyzed and compared between both groups. In addition, the influence of coagulation parameters on progression-free, recurrence-free and overall survival was investigated. The ICI cohort presented significantly increased factor VIII activity after one week of therapy (p 0.0225); while, protein S activity was reduced during the whole observation period. Additionally, von Willebrand factor activity and tissue factor concentrations increased under immunotherapy. Similar changes occurred under BRAF/MEK inhibitor therapy (BRAF/MEKi). Increased baseline levels of von Willebrand factor antigen and factor VIII:C before the start of ICI therapy correlated with a significantly higher risk of recurrence for patients receiving adjuvant immunotherapy. The findings suggest the induction of a pro-coagulant state under ICI and BRAF/MEKi and a role of coagulation parameters in the efficacy of ICI therapies.

Indexed as

Blood CoagulationImmunotherapyProto-Oncogene Proteins B-rafAdultAgedAged, 80 and overFemaleHumansImmune Checkpoint InhibitorsMaleMiddle AgedProspective StudiesProtein Kinase InhibitorsSkin NeoplasmsBRAF protein, humanImmune Checkpoint InhibitorsProtein Kinase InhibitorsProto-Oncogene Proteins B-rafBRAF/MEK inhibitorsCoagulation–fibrinolysis disordersICI-associated thrombosisImmune checkpoint inhibitorsMelanomaPredictive marker

Identifiers

PMID39487855
PMCPMC11531462

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.