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Published on: February 5, 2020
Safety profile of immune checkpoint inhibitors according to cancer type
Chloé Guérin1, Mathieu Laramas2, François Bettega3
1Grenoble Alpes University Hospital, Department of Internal Medicine/Clinical Immunology, Grenoble, France.
Introduction:
Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment in recent years, but have led to the emergence of new so-called immune-related adverse events (irAE). The objective of this study was to determine whether cancer type is a potential predictive factor of irAEs.
Methods:
This retrospective study included patients who had started an ICI treatment between 2019 and 2020 at the Grenoble Alpes University Hospital. A logistic regression model and a Fine and Gray survival model with death as a competing risk were used to identify variables associated with grade≥2 irAEs and grade≥2 irAEs-free survival.
Results:
Of the 512 patients included, 160 (31.2%) had a grade≥2 irAE. Grade≥2 irAEs were less frequent in head and neck cancer compared to other cancers. Ipilimumab (odds ratio [OR]: 6.05; 95% confidence interval [CI]: 2.81-13.7), treatment duration (OR: 1.01; 95% CI: 1.01-1.02), and history of autoimmune disease (OR: 6.04; 95% CI: 2.45-16.5) were independently associated with grade≥2 irAEs. With death as a competing risk, grade≥2 irAEs-free survival was independently improved with treatment duration (subdistribution hazard ratio [sdHR]: 0.93; 95% CI: 0.92-0.94), ipilimumab (sdHR: 0.24; 95% CI: 0.1-0.59) and history of autoimmune disease (sdHR: 0.23; 95% CI: 0.08-0.69) whereas it was poorer for patients with performance status≥2 (sdHR: 2.04; 95% CI: 1.5-2.76) and an older age (sdHR: 1.02; 95% CI: 1.00-1.03).
Conclusion:
Ipilimumab and history of autoimmune disease were both associated with the presence of grade≥2 irAEs and grade≥2 irAEs-free survival. The different cancer groups were not.
Insights
Immune checkpoint inhibitors (ICI) can cause immune-related adverse events (irAEs). This study found ipilimumab and autoimmune disease history predict irAEs, while cancer type did not significantly influence their occurrence.
Area of Science:
- Oncology
- Immunology
- Clinical Research
Background:
- Immune checkpoint inhibitors (ICI) have transformed cancer therapy, introducing immune-related adverse events (irAEs).
- Understanding predictive factors for irAEs is crucial for patient management and treatment optimization.
Purpose of the Study:
- To investigate whether cancer type is a predictive factor for the occurrence of grade ≥2 immune-related adverse events (irAEs).
- To identify patient and treatment-related factors associated with irAEs and irAEs-free survival.
Main Methods:
- Retrospective analysis of 512 patients treated with ICI between 2019-2020.
- Logistic regression and Fine and Gray survival models were employed to analyze associations with grade ≥2 irAEs and irAEs-free survival, considering death as a competing risk.
Main Results:
- Grade ≥2 irAEs occurred in 31.2% of patients; they were less frequent in head and neck cancers.
- Ipilimumab, longer treatment duration, and a history of autoimmune disease were independently associated with increased grade ≥2 irAEs.
- Grade ≥2 irAEs-free survival was positively influenced by treatment duration, ipilimumab, and autoimmune disease history, but negatively by poor performance status and older age.
Conclusions:
- Ipilimumab and a history of autoimmune disease are significant predictors of grade ≥2 irAEs and influence irAEs-free survival.
- Cancer type was not found to be a significant predictive factor for irAEs in this cohort.
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