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Title: Changes in bone turnover markers in patients without bone metastases receiving immune checkpoint inhibitors: An exploratory analysis
Author: Pantano, Francesco
Tramontana, Flavia
Iuliani, Michele
Leanza, Giulia
Simonetti, Sonia
Piccoli, Alessandra
Paviglianiti, Annalisa
Cortellini, Alessio
Spinelli, Gian Paolo
Longo, Umile Giuseppe
Strollo, Rocky
Vincenzi, Bruno
Tonini, Giuseppe
Napoli, Nicola
Santini, Daniele
Keywords: Malalties dels ossos
Bone diseases
Issue Date: 27-Oct-2022
Publisher: Elsevier BV
Abstract: Immune checkpoint inhibitors (ICIs) has revolutionized the treatment of different advanced solid tumors, but most patients develop severe immune-related adverse events (irAEs). Although a bi-directional crosstalk between bone and immune systems is widely described, the effect of ICIs on the skeleton is poorly investigated. Here, we analyze the changes in plasma levels of type I collagen C-terminal telopeptide (CTX-I) and N-terminal propeptide of type I procollagen (PINP), reference makers of bone turnover, in patients treated with ICIs and their associ-ation with clinical outcome.A series of 44 patients affected by advanced non-small cell lung cancer or renal cell carcinoma, without bone metastases, and treated with ICIs as monotherapy were enrolled. CTX-I and PINP plasma levels were assessed at baseline and after 3 months of ICIs treatment by ELISA kits.A significant increase of CTX-I with a concomitant decreasing trend towards the reduction of PINP was observed after 3 months of treatment. Intriguingly, CTX-I increase was associated with poor prognosis in terms of treatment response and survival. These data suggest a direct relationship between ICIs treatment, increased osteoclast activity and potential fracture risk.Overall, this study reveals that ICIs may act as triggers for skeletal events, and if confirmed in larger pro-spective studies, it would identify a new class of skeletal-related irAEs.
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It is part of: Journal of Bone Oncology, 2022, vol. 37, p. 100459
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ISSN: 2212-1374
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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