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Oral immune-related adverse events caused by immune checkpoint inhibitors: a retrospective study
Michele DI Cosola1, Francesca Spirito2, Piermichele Saracino1
1Department of Clinical and Experimental Medicine, Riuniti University Hospital of Foggia, Foggia, Italy.
Background:
Immune Checkpoint inhibitors (ICI) are linked to a series of adverse systemic and/or oral side effects such as "stomatitis," "oral inflammation" and "mucositis." These oral lesions induced by target therapies and immune checkpoint inhibitors are different from traditional lesions associated with chemo/radiotherapy and they have not yet been correctly characterized. This paper aims to report retrospectively the oral immune-related adverse events caused by immune checkpoint inhibitors.
Methods:
A table in electronic format was prepared and sent by e-mail to several clinical structures in order to collect, for each patient, anamnestic data, discretionary habits, systemic risk factors, the presence and number of comorbidities, and the characteristics of the oral lesions in the course of oncological therapy with anti-PD1 (nivolumab, pembrolizumab). Following the collection of anamnestic and clinical data relating to patients treated with anti-PD1 (nivolumab, pembrolizumab) and the detection of oral lesions, data analysis was carried out.
Results:
A number of 364 patients treated with nivolumab (209) and pembrolizumab (155), administered intravenously at a therapeutic dose were selected. There have been cases of oral adverse effects in treated patients. The oral adverse effects found fell into the categories of stomatitis, xerostomia, candidiasis and taste disturbances. Analyzing the incidence of oral lesions in patients undergoing treatment with immune checkpoint inhibitors, there was no significant difference between the two drugs examined.
Conclusions:
Further studies are certainly needed to catalog, focus and identify in advance the adverse effects, including oral ones, in patients treated with ICI type PD1/PDL-1. It is necessary, for the benefit of patients, to pay particular attention to the adverse effects in order to recognize, treat and possibly modulate the therapy with an adequate assessment of the cost/benefit ratio and quality of life.
Insights
Immune checkpoint inhibitors (ICI) can cause oral side effects like stomatitis and xerostomia. This study found no significant difference in oral adverse events between nivolumab and pembrolizumab treatments.
Area of Science:
- Oncology
- Immunology
- Oral Medicine
Background:
- Immune checkpoint inhibitors (ICI) are associated with systemic and oral adverse events, including stomatitis, oral inflammation, and mucositis.
- Oral lesions from ICI differ from traditional chemotherapy/radiotherapy-induced lesions and require specific characterization.
- This study retrospectively analyzes oral immune-related adverse events (irAEs) induced by ICI therapy.
Purpose of the Study:
- To retrospectively report and characterize oral immune-related adverse events (irAEs) in patients treated with anti-PD1 immune checkpoint inhibitors.
- To compare the incidence and types of oral lesions between nivolumab and pembrolizumab treatments.
Main Methods:
- A retrospective data collection was performed using an electronic table sent to clinical centers.
- Data included patient history, habits, comorbidities, and characteristics of oral lesions during anti-PD1 therapy (nivolumab, pembrolizumab).
- Anamnestic and clinical data were analyzed following the detection of oral lesions.
Main Results:
- 364 patients treated with nivolumab (209) or pembrolizumab (155) were analyzed.
- Oral adverse effects observed included stomatitis, xerostomia, candidiasis, and taste disturbances.
- No significant difference in the incidence of oral lesions was found between nivolumab and pembrolizumab treatments.
Conclusions:
- Further research is needed to catalog and identify oral adverse effects of PD1/PDL-1 inhibitors.
- Close attention to oral adverse events is crucial for timely recognition, treatment, and therapy modulation to maintain patient quality of life.
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