Impact of Immune-Related Adverse Events on Immune Checkpoint Inhibitors Treated Cancer Patients’ Survival: Single Center Experience and Literature Review
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Patient and Tumor Characteristics
3.2. Immune-Related Adverse Events
3.3. Response Rate and Survival Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Whole Cohort n (%) | irAE n (%) | non-irAE n (%) |
---|---|---|---|
Age (years) | |||
Median (range) | 64 (21–86) | 64 (36–86) | 65 (21–85) |
Sex | |||
Male | 118 (76.1) | 52 (74.3) | 66 (77.6) |
Female | 37 (23.9) | 18 (25.7) | 19 (22.4) |
Tumor type | |||
Lung, non-small cell | 76 (49.0) | 42(60) | 34 (40.0) |
Melanoma | 28 (18.1) | 16 (22.8) | 12 (14.2) |
Renal | 18 (11.6) | 7(10.0) | 11 (12.9) |
Head and neck | 17 (11.0) | 2 (2.9) | 15 (17.6) |
Bladder | 11 (7.1) | 3 (4.3) | 8 (9.4) |
Others | 5 (3.2) | - | 5 (6.0) |
ECOG PS | |||
0 | 38 (24.5) | 17 (24.3) | 21 (24.7) |
1 | 101 (65.2) | 46 (65.7) | 55 (64.7) |
2 | 16 (10.3) | 7 (10.0) | 9 (10.6) |
Treatment Line | |||
First | 50 (32.3) | 28 (40.0) | 22 (25.9) |
Second | 91 (58.7) | 37 (52.9) | 54 (63.5) |
Third | 11 (7.1) | 5 (7.1) | 6 (7.1) |
Fifth or later | 3 (1.9) | - | 3 (3.6) |
Type of Immune Checkpoint inhibitor | |||
Anti-PD-1/PD-L1 | 146 (94.2) | 66 (94.3) | 80 (94.1) |
Anti-CTLA-4 | 9 (5.8) | 4 (5.7) | 5 (5.9) |
Variables | n (%) |
---|---|
Treatment-related irAEs | |
yes | 70 (45.2) |
no | 85 (54.8) |
Grade of irAE | |
<3 | 91 (92.9) |
≥3 | 9 (8.1) |
Frequency of irAEs | |
1 | 33(47.1) |
2 | 26 (37.1) |
3 | 11(15.71) |
Type of irAE | |
Dermatologic | 34 (35.4) |
Pruritus | 18(18.7) |
Rash | 14(14.7) |
Vitiligo | 1(1.0) |
Bullous pemphigoid | 1(1.0) |
Neurologic/Musculoskeletal | 13 (13.5) |
Myalgias | 12 (12.5) |
Immune-mediated necrotizing myopathy | 1(1.0) |
Endocrin | 14(14.7) |
Hypothyroidism | 11 (11.5) |
Hypertiroidism | 3 (3.2) |
Rheumatologic | 17 (17.7) |
Artralgias | 16 (16.7) |
Vasculitis | 1(1.0) |
Pulmonary | 8(8.3) |
Pneumonitis | 8 (8.3) |
Gastrointestinal and Hepatic and biliary | 9 (9.4) |
Diarrhea | 2 (2.1) |
Colitis | 2 (2.1) |
Hepatitis | 3 (3.2) |
Colangitis | 1 (1.0) |
Colestases | 1 (1.0) |
Renal | 1 (1.0) |
Nephritis | 1 (1.0) |
Treatment of irAE | |
Supportive care | 66 (94.3) |
Oral Corticosteroid | 27 (38.6) |
Intravenous Corticosteroid | 5 (7.1) |
Other Immunosuppressor (Methotrexate) | 1(1.4) |
Predictable Variables | HR Crude (CI 95%) | p Value | HR Adjusted (CI 95%) | p Value |
---|---|---|---|---|
irAE Yes vs. No | 0.67 (0.46–0.99) | 0.043 | 0.65 (0.44–0.96) | 0.03 |
Sex Male vs. female | 0.73 (0.48–1.12) | 0.152 | ||
ECOG PS 1 vs. 0 | 1.84 (1.12–3.03) | 0.017 | 1.81 (1.10–2.88) | 0.020 |
2 vs. 0 | 3.50 (1.72–7.11) | 0.001 | 3.73 (1.83–7.62) | 0.000 |
Age <65 vs. ≥65 | 0.95 (0.65–1.30) | 0.771 | ||
Treatment Line 1 vs. ≥2 | 1.29 (0.85–1.98) | 0.230 | ||
Type of tumor NSCLC vs. other | 0.75 (0.52–1.11) | 0.151 | ||
Grade of toxicity <3 vs. ≥3 | 0.46 (0.19–1.14) | 0.094 |
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Romão, R.; Mendes, A.S.; Ranchor, R.; Ramos, M.J.; Coelho, J.; Pichel, R.C.; Azevedo, S.X.; Fidalgo, P.; Araújo, A. Impact of Immune-Related Adverse Events on Immune Checkpoint Inhibitors Treated Cancer Patients’ Survival: Single Center Experience and Literature Review. Cancers 2023, 15, 888. https://doi.org/10.3390/cancers15030888
Romão R, Mendes AS, Ranchor R, Ramos MJ, Coelho J, Pichel RC, Azevedo SX, Fidalgo P, Araújo A. Impact of Immune-Related Adverse Events on Immune Checkpoint Inhibitors Treated Cancer Patients’ Survival: Single Center Experience and Literature Review. Cancers. 2023; 15(3):888. https://doi.org/10.3390/cancers15030888
Chicago/Turabian StyleRomão, Raquel, Ana S. Mendes, Ridhi Ranchor, Maria João Ramos, João Coelho, Rita Carrilho Pichel, Sérgio Xavier Azevedo, Paula Fidalgo, and António Araújo. 2023. "Impact of Immune-Related Adverse Events on Immune Checkpoint Inhibitors Treated Cancer Patients’ Survival: Single Center Experience and Literature Review" Cancers 15, no. 3: 888. https://doi.org/10.3390/cancers15030888