{"doi":"10.1371/journal.pone.0339671","title":"The immune checkpoint inhibitor avelumab increases aortic inflammation on [18F]FDG PET/CT: A retrospective cohort study","abstract":"BACKGROUND: Patients with cancer treated with immune checkpoint inhibitors (ICIs) are at increased risk of cardiovascular events. Preclinical studies suggest that this may result from inflammation-induced destabilization of atherosclerotic plaques. OBJECTIVE: To evaluate changes in vessel wall inflammation assessed using [18F]FDG positron emission tomography/computed tomography (PET/CT) after ICI initiation. METHODS: This was a single-center retrospective cohort study of patients with Merkel cell carcinoma who received at least one cycle of the programmed death ligand 1 (PD-L1) inhibitor avelumab and underwent [18F]FDG PET/CT before initiation of treatment and after 3 months. The primary outcome was the change in the target-to-background ratio (TBRmax) in the descending aorta between baseline and first follow-up scan. Secondary outcomes included the change in TBRmax in the carotid arteries, spleen, and bone marrow, and incidence of major adverse cardiovascular events. RESULTS: Fifty-three patients were included (66% male; median age 75 years). Most patients had established risk factors for cardiovascular disease (62%). The [18F]FDG TBRmax in the descending aorta increased from 1.52 (IQR, 1.39-1.70) at baseline to 1.64 (IQR, 1.41-1.97) after 3 months of treatment (change 7.8%. p = 0.022). No significant changes were observed in the carotid arteries, bone marrow, and spleen. Statin use was not associated with an attenuated change in TBRmax. During a median follow-up of 2.3 (IQR, 1.5-4.2) years, one nonfatal ischemic stroke occurred. CONCLUSION: Avelumab treatment was associated with an increase in [18F]FDG uptake in the descending aorta after 3 months of treatment, which may be a potential marker of inflammation-driven accelerated atherosclerosis in patients receiving ICIs.","journal":"PLoS ONE","year":2025,"id":587374,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9672,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1502340,"name":"Reindert F. Oostveen","orcid":"0000-0001-7182-2886","position":1,"is_corresponding":false},{"id":1503127,"name":"Mark P.A. Schilder","orcid":null,"position":2,"is_corresponding":false},{"id":1503128,"name":"Arthur J.A.T. Braat","orcid":null,"position":3,"is_corresponding":false},{"id":1502341,"name":"Youssef Chahid","orcid":"0000-0002-6223-3454","position":4,"is_corresponding":false},{"id":259171,"name":"Damini Dey","orcid":"0000-0003-2236-6970","position":5,"is_corresponding":false},{"id":254357,"name":"Nordin M.J. Hanssen","orcid":"0000-0001-9541-7244","position":6,"is_corresponding":false},{"id":1503129,"name":"Hanneke WM van Laarhoven","orcid":null,"position":7,"is_corresponding":false},{"id":1502342,"name":"Anne W. van Schijndel","orcid":"0000-0001-5774-675X","position":8,"is_corresponding":false},{"id":294519,"name":"Tom Seijkens","orcid":"0000-0001-6370-1267","position":9,"is_corresponding":false},{"id":1503130,"name":"Piotr J Slomka","orcid":null,"position":10,"is_corresponding":false},{"id":50111,"name":"Erik S.G. Stroes","orcid":"0000-0001-9555-6260","position":11,"is_corresponding":false},{"id":1502343,"name":"Margot Tesselaar","orcid":"0000-0002-8885-4638","position":12,"is_corresponding":false},{"id":513504,"name":"Hein J. Verberne","orcid":"0000-0003-3774-2414","position":13,"is_corresponding":false},{"id":1058349,"name":"Nick van Es","orcid":"0000-0001-5256-6346","position":14,"is_corresponding":false},{"id":1502339,"name":"Anniek Strijdhorst","orcid":"0009-0009-8033-7298","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-19T02:59:36.020030Z","pmid":"41460790","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}