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Risk factors and predictors of immune-related adverse events: implications for patients with non-small cell lung
Majd Issa1, Joy Tang1, Yizhen Guo2
1Division of Medical Oncology, Department of Internal Medicine, the Ohio State University Wexner Medical Center - Comprehensive Cancer Center, Columbus, USA.
Introduction:
Immune checkpoint inhibitors (ICI) are now utilized as a standard of care treatment for multiple cancers, including in both the metastatic setting as well as in earlier stages of disease. The identification of unique immune-related adverse events (irAE) that occur during ICI treatment has led to intense research to identify potential risk factors and biomarkers that may assist in clinical decision making. Although initial studies in ICI were primarily in advanced stage disease, the use of ICI in earlier stages of disease as adjuvant therapies requires a better understanding of patient risk stratification to mitigate or prevent serious irAE.
Areas Covered:
In this review, we set out to describe the current state of research regarding potential risk factors for irAE in patients with non-small cell lung cancer, as well as explore the barriers to understanding irAE. We review data from irAE that occur in large phase 3 trials and prospective studies focusing on irAE, as well as the many retrospective studies that currently form the bulk of our understanding of irAE.
Insights
Immune checkpoint inhibitors (ICI) are crucial cancer treatments. Understanding immune-related adverse events (irAE) risk factors is vital for patient safety, especially in early-stage non-small cell lung cancer.
Area of Science:
- Oncology
- Immunology
Background:
- Immune checkpoint inhibitors (ICI) are standard cancer treatments.
- Immune-related adverse events (irAE) are a concern with ICI therapy.
- Risk stratification for irAE is needed, particularly for early-stage disease.
Purpose of the Study:
- To review current research on irAE risk factors in non-small cell lung cancer (NSCLC).
- To explore challenges in understanding irAE.
- To synthesize data from various study types on irAE in NSCLC.
Main Methods:
- Literature review of irAE in NSCLC.
- Analysis of data from phase 3 trials and prospective studies.
- Inclusion of findings from retrospective studies.
Main Results:
- Current understanding of irAE in NSCLC is largely based on retrospective data.
- Barriers to understanding irAE exist.
- Further research is needed for robust risk stratification.
Conclusions:
- A comprehensive understanding of irAE risk factors is essential for safe ICI use.
- Improved risk stratification can mitigate serious irAE.
- Continued research is critical for optimizing ICI therapy in NSCLC.
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