Patterns of Cutaneous and Noncutaneous Immune-Related Adverse Events Among Patients With Advanced Cancer

Area of Science:

• Oncology
• Immunology
• Dermatology

Background:

• Cutaneous immune-related adverse events (cirAEs) are early toxic reactions to immune-checkpoint inhibitors (ICIs).
• Associations between cirAEs and noncutaneous immune-related adverse events (irAEs) are underexplored.
• cirAEs may indicate broader immune-mediated toxic effects.

Purpose of the Study:

• To characterize patterns of cirAEs and irAEs.
• To examine associations between first cirAE features and overall irAE risk.
• To investigate links between cirAEs and specific irAE subtypes.

Main Methods:

• Retrospective cohort study at an academic medical center.
• Included 358 cancer patients treated with ICI therapy.
• Identified cirAEs via ICD codes and manual review.

Main Results:

• Nearly half of patients (49.4%) with cirAEs developed noncutaneous irAEs.
• Mucositis associated with increased overall irAE risk (OR 5.28) and gastrointestinal irAEs (OR 5.70).
• Psoriasis associated with increased risk of endocrine irAEs (OR 4.54).

Conclusions:

• cirAEs are associated with multisystem toxic effects in patients on ICI therapy.
• Dermatologists may play a role in managing noncutaneous toxic effects.
• Findings highlight the predictive value of early skin toxicities.