So-called immune checkpoint inhibitors (ICIs) have been used successfully in cancer treatment for several years: these are drugs that ‘boost’ the body’s own immune system so that it can attack cancer cells more aggressively. However, cancer patients receiving ICI therapy are at an increased risk of heart disease. An interdisciplinary research team led by Prof. Dr Lorenz Lehmann, of the Heidelberg Medical Faculty at Heidelberg University and Head of the Cardio-Oncology Section at the Department of Cardiology, Angiology and Pneumology at Heidelberg University Hospital (Medical Director: Prof. Dr Norbert Frey), is investigating the biological mechanisms that cause these side effects.
The consortium includes Dr Isabel Poschke from the German Cancer Research Centre (DKFZ) in Heidelberg, Dr Henrike Maatz from the Max Delbrück Centre for Molecular Medicine in Berlin, Prof. Dr Sylvia Saalfeld, Department of Medical Informatics at the University of Kiel, and Prof. Dr Oliver Müller, Medical Director of the Department of Internal Medicine V at the University Medical Centre Schleswig-Holstein in Kiel. Since 1st of February 2026, the Hector Foundation has been funding the work of the consortium, known as ATHERIC-CARE (ATHErosclerosis RIsk In Cancer patients after immune Checkpoint-Inhibitor therapy – Assessment and Exploration), over a period of three years with a total of 1.3 million euros.
“We believe that cancer patients undergoing immunotherapy with checkpoint inhibitors have an approximately threefold increased risk of heart conditions such as coronary heart disease,” says project leader Prof. Lehmann. Coronary heart disease is atherosclerosis of the coronary arteries. In this chronic inflammatory condition, blood lipids, cholesterol and other substances from the blood stick to the inner walls of the blood vessels and trigger persistent inflammation. Over time, these ‘plaques’ expand and increasingly narrow the blood vessels. This can lead to heart failure and heart attacks. “The innovative consortium is interested in how checkpoint inhibitors activate or accelerate this inflammatory mechanism and is making an important contribution to this new interdisciplinary field of research,” says Prof. Norbert Frey.
As part of the funded project, the researchers are using DNA analysis to investigate which immune cells drive atherosclerosis, examining the inflammatory mechanisms from the very outset in animal experiments, and analysing CT scans of patients using machine learning. Prof. Lehmann’s team will analyse imaging data from patients with malignant melanoma at Heidelberg University Hospital. This form of skin cancer is one of the malignant tumours for which ICI therapy is successfully used – typically as a long-term treatment spanning several years. As malignant melanoma can metastasise rapidly to other organs even in its early stages, patients undergo regular computed tomography (CT) scans, amongst other tests. Although this imaging data is primarily intended for monitoring metastases, it can also reveal changes in arterial vessels, such as the coronary arteries, when analysed using artificial intelligence.
“By bringing together the findings from the consortium’s various research areas, we aim to identify biomarkers and strategies that will make immunotherapy safer – and thereby also improve patients’ quality of life,” says Prof. Lehmann, summarising the project’s objectives.
Source: Press release Heidelberg University Hospital
