Impact of Checkpoint Inhibitor Immunotherapy, Primarily Pembrolizumab, on Infection Risk in Patients With Advanced...

Area of Science:

• Oncology
• Immunotherapy
• Infectious Disease

Background:

• Checkpoint inhibitor (CPI) immunotherapy has transformed cancer treatment.
• The infectious risk associated with CPIs, particularly when combined with conventional chemotherapy (CC), requires further investigation.
• Understanding immune-related adverse events is crucial for patient safety.

Purpose of the Study:

• To evaluate and compare the incidence of infections in lung cancer patients treated with CPIs plus CC versus CC alone.
• To identify risk factors for infection and mortality in patients receiving CPIs.

Main Methods:

• Retrospective comparative study of advanced non-small cell lung cancer patients.
• Data collected from January 2016 to February 2019.
• Comparison of clinical characteristics, treatments, infection rates, and mortality between CPI + CC and CC alone groups.

Main Results:

• 123 patients in the CPI group and 147 in the control group.
• Infection incidence was 15% in the CPI group vs. 22% in the control group (P=0.1).
• Pneumonia was the most common infection; urinary tract infections were significantly lower in the CPI group (9% vs. 40%, P=0.01).

Conclusions:

• Lung cancer patients receiving CPIs combined with CC have a comparable infection risk to those on CC alone.
• A trend towards fewer infections, especially urinary tract infections, was observed in the CPI group.
• COPD, prior corticosteroid use, and neutropenia were independent risk factors for infection.