{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:25:43Z","timestamp":1776259543567,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) significantly improve cancer prognosis but are associated with the risk of immune checkpoint inhibitor-related cardiotoxicity (iRCs), a life-threatening complication. Type 2 Diabetes Mellitus (T2DM) further increases the risk of iRCs and worsens outcomes in these patients. Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) confer cardioprotective and potential antitumor effects, their prognostic value in cancer patients with T2DM and established iRCs remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association of SGLT2i use with all-cause mortality, iRCs severity, and major adverse cardiovascular events (MACE) in cancer patients with T2DM who developed iRCs during ICI therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, we analyzed 98 cancer patients with T2DM and established iRCs between January 2019 and June 2025. Participants were categorized into an SGLT2i group (n = 26) and a non-SGLT2i group (n = 72). The primary endpoint was all-cause mortality; secondary endpoints included 40-day MACE and iRCs severity. Survival analyses were performed using Kaplan-Meier curves with the log-rank test. Independent associations were assessed via Cox proportional hazards regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median follow-up was 950.5 days. SGLT2i use was independently associated with reduced all-cause mortality (adjusted HR\u00a0=\u00a00.520, 95% CI: 0.285\u20130.947, p = 0.033). The SGLT2i group exhibited a longer median survival time (743 days vs. 494 days) and consistently higher 1-, 2-, and 3-year survival rates (73.1% vs. 60.6%; 51.5% vs. 26.4%; 31.2% vs. 8.8%) compared to the non-SGLT2i group. Additionally, the SGLT2i group had a significantly lower proportion of high-grade iRCs (19.2% vs. 45.8%, p = 0.031). Although the incidence of MACE did not differ significantly between groups (19.2% vs. 33.3%, p = 0.271), univariate Cox regression indicated a 47% lower risk of MACE in the SGLT2i group (HR\u00a0=\u00a00.531, 95% CI: 0.202\u20131.391, p = 0.198), with numerical reductions observed for both overall MACE and its individual components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SGLT2i use in cancer patients with T2DM and established iRCs was independently associated with lower all-cause mortality and linked to a reduced incidence of high-grade iRCs and favorable MACE trends. These findings warrant prospective validation to confirm cardioprotective and potential oncologic benefits of SGLT2i in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1776717","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:32:08Z","timestamp":1776256328000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sodium-glucose cotransporter-2 inhibitors in cancer patients with type 2 diabetes and established immune checkpoint inhibitor-related cardiotoxicity: a retrospective analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Ling","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, 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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengkun","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yansong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingtao","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, 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