{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:14:00Z","timestamp":1790201640056,"version":"4.1.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate changes in vessel wall inflammation assessed using [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG positron emission tomography\/computed tomography (PET\/CT) after ICI initiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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 [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT before initiation of treatment and after 3 months. The primary outcome was the change in the target-to-background ratio (TBR\n                      <jats:sub>max<\/jats:sub>\n                      ) in the descending aorta between baseline and first follow-up scan. Secondary outcomes included the change in TBR\n                      <jats:sub>max<\/jats:sub>\n                      in the carotid arteries, spleen, and bone marrow, and incidence of major adverse cardiovascular events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-three patients were included (66% male; median age 75 years). Most patients had established risk factors for cardiovascular disease (62%). The [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG TBR\n                      <jats:sub>max<\/jats:sub>\n                      in the descending aorta increased from 1.52 (IQR, 1.39\u20131.70) at baseline to 1.64 (IQR, 1.41\u20131.97) after 3 months of treatment (change 7.8%. p\u2009=\u20090.022). No significant changes were observed in the carotid arteries, bone marrow, and spleen. Statin use was not associated with an attenuated change in TBR\n                      <jats:sub>max.<\/jats:sub>\n                      During a median follow-up of 2.3 (IQR, 1.5\u20134.2) years, one nonfatal ischemic stroke occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Avelumab treatment was associated with an increase in [\n                      <jats:sup>18<\/jats:sup>\n                      F]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.\n                    <\/jats:p>\n                  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