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Lung Cancer Research Studies · Journal article
Cardio-oncology · September 4, 2026
Early or partial results. Treat as a signal, not a conclusion.
This single-center retrospective cohort of 162 ICI-treated patients found that baseline cardiac troponin I and CK-MB were associated with new-onset ECG abnormalities (HR 2.00 and 2.54 respectively, both p≤0.003), but discrimination was modest (C-index 0.645) and estimates were apparent and in-sample. The authors acknowledge that ECG abnormalities do not equal definite ICI-related cardiotoxicity and call for prospective multicenter validation before these findings should guide clinical monitoring.
Single-center retrospective cohort study. 162 patients with advanced gastrointestinal or lung cancers enrolled at a single center; all received ≥2 cycles of ICI monotherapy or ICI-based combination therapy.. Intervention: Immune checkpoint inhibitor monotherapy or combination therapy. n = 162. Single center (not specified).
New-onset ECG abnormalities occurred in 86 patients (53.1%); Grade ≥2 abnormalities in 25 patients (15.4%) Baseline cTnI >0.02 ng/mL associated with shorter time to new-onset ECG abnormality (HR 2.00; 95% CI 1.26–3.18; p=0.003) Baseline CK-MB >13 U/L associated with shorter time to new-onset ECG abnormality (HR 2.54; 95% CI 1.60–4.01; p<0.001)
ECG abnormalities are surrogate endpoints and authors explicitly note they do not confirm ICI-related cardiotoxicity
These exploratory findings suggest baseline troponin and CK-MB may help identify ICI-treated patients at higher risk for new-onset ECG abnormalities, but the modest discrimination and acknowledged lack of prospective validation mean these biomarkers should not yet guide routine clinical monitoring decisions. Prospective multicenter studies are needed before implementation.
Single-center retrospective cohort with modest discrimination (C-index 0.645), apparent in-sample estimates, and modest effects; exploratory analyses lack prospective validation and cannot yet inform clinical practice.
As stated by the source record.
Quoted from the source exactly as published.
These exploratory findings suggest baseline troponin and CK-MB may help identify ICI-treated patients at higher risk for new-onset ECG abnormalities, but the modest discrimination and acknowledged lack of prospective validation mean these biomarkers should not yet guide routine clinical monitoring decisions. Prospective multicenter studies are needed before implementation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Routine inflammatory and cardiac biomarkers may help risk-stratify patients receiving immune checkpoint inhibitors (ICIs). The ECG monitoring endpoint and oncologic survival outcomes are distinct. We examined whether baseline cardiac biomarkers were associated with adjudicated new-onset electrocardiographic (ECG) abnormalities after ICI initiation and whether inflammatory and cardiac biomarkers were associated with overall survival (OS) and progression-free survival (PFS). This single-center retrospective cohort included 162 patients with advanced gastrointestinal or lung cancers who received at least two cycles of ICI monotherapy or ICI-based combination therapy. The ECG monitoring endpoint was any adjudicated new-onset ECG abnormality. Baseline ECGs were used to identify pre-existing findings, and ICI initiation was the time origin for the 12-month Cox, Kaplan–Meier, and score analyses. Patients without an event were censored at the earliest of the last evaluable ECG date, death, or 365 days after ICI initiation. ECGs were independently reviewed by two cardiologists, and disagreements were resolved by consensus. Logistic regression and Cox models were used for ECG, OS, and PFS analyses; age-stratified Cox sensitivity analyses addressed non-proportionality. New-onset ECG abnormalities occurred in 86 patients (53.1%). Study-defined Grade ≥ 2 ECG abnormalities occurred in 25 patients (15.4%). Binary normal/abnormal classification was concordant in all 162 patients, and Cohen’s kappa for the specific primary ECG type was 0.975. In the adjusted 12-month Cox model, cTnI > 0.02 ng/mL (HR, 2.00; 95% CI, 1.26–3.18; P = 0.003) and CK-MB > 13 U/L (HR, 2.54; 95% CI, 1.60–4.01; P < 0.001) were associated with shorter time to the first documented adjudicated new-onset ECG abnormality. Age showed non-proportionality, but biomarker estimates were similar in age-stratified sensitivity models. The 3-point score had modest apparent, in-sample discrimination (C-index, 0.645). During follow-up, 53 deaths and 137 PFS events occurred. cTnI remained associated with both OS and PFS after forced adjustment. Baseline cTnI and CK-MB were associated with the first documented adjudicated new-onset ECG abnormality, although discrimination was modest and performance estimates were apparent and in-sample. Separately, cTnI, D-dimer, NLR, and ECOG performance status contributed to exploratory survival risk stratification. ECG abnormalities should not be interpreted as definite ICI-related cardiotoxicity. Prospective multicenter validation is required before these findings can inform clinical monitoring strategies.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.