Factors affecting the level of arterial stiffness in cancer patients taking immunotherapy

Purpose and Hypothesis: The aim of our study is to investigate the factors affecting the level of arterial stiffness in cancer patients receiving immunotherapy in our clinic. Methods: The study was conducted prospectively with 42 patients with the diagnosis of malignant melanoma, lung cancer, and RCC receiving follow-up immunotherapy treatment in our clinic between June 2021 and June 2022. The patients' height, weight, BMI, age, gender, type of cancer, previous treatment for cancer, agents used in the treatment, current immunotherapy agents, comorbid conditions, smoking history of the patients were recorded, and arterial stiffness levels were measured at the time of first admission. After the first measurement, the patients were seen again in the third and sixth cycles, their measurements were repeated and recorded. It was evaluated whether age, gender, BMI, cancer type, previous chemotherapy, previous braf inhibitor, previous tyrosine kinase inhibitor, immunotherapy agent being used, presence of comorbid disease, smoking status affected the arterial stiffness level. Results: In our study, the most common gender was male, and the female/male ratio was 1/5. There was no significant difference between gender and NDH. However, the pulse pressure of women was higher than that of men (p<0.009). 22 (52.3%) of the patients were over 65 years old, 20 (7.7%) were 65 years old and younger; The mean age was 63 years.NDH increased with increasing age (p<0.01). The mean BMI of the patients was 25 kg/m², no correlation was found between BMI and NDH. Nine (21.4%) of the patients were malignant melanoma, 6 (14.3%) renal cell cancer, 27 (64.3%) lung cancer. There was no significant difference between cancer type and NDH; however, patients with lung cancer had a higher pulse pressure at the first measurement compared to malignant melanoma and RCC. 41 (97.6%) of the patients were taking nivolumab and 1 (2.4%) were taking pembrolizumab. There was no significant difference between immunotherapy agents and NDH. While 18 (42.9%) of the patients did not have any additional disease, 24 (57.1%) had any additional disease (at least one or more). When the NDH of the patients with and without additional disease was examined, it was found to be significantly higher in those with additional disease (p<0.005). However, when NDH was examined among patients with any of the HT, DM, CAD, no significant difference was found in NDH between the diseases. Of the patients, 12 (28.6%) had never smoked, 19 (45.2%) had quit, and 11 (26.2) were active smokers. When the NDH of smokers and non-smokers was examined, no statistically significant difference was found. However, the pulse pressure of smokers was higher than non-smokers (p< 0.007). When 6 (14.2%) of the patients had received CT before and 36 (85.7%) did not, there was no significant difference when these patients were compared with NDH. No correlation was found between the number of courses of CT received by patients who had previously received CT and NDH. When 2 (4.7%) of the patients had taken a braf inhibitor before, 40 (95.2%) did not, no significant difference was found when the NDH of these patients was compared. When 6 (14.3%) of the patients had taken tyrosine kinase inhibitor before and 36 (85.7%) of them did not, there was no significant difference when NDH was compared. Conclusion: In cancer patients receiving immunotherapy, smoking, gender and cancer type were different in the change in pulse pressure, but there was no significant difference in other factors; NDH, on the other hand, increases with increasing age; It was concluded that those with additional disease had higher NDH. Keywords: Cancer immunotherapy, arterial stiffness, affecting factors