Pre-Existing Inflammatory Disease Predicts Cutaneous Immunotherapy Toxicity Development: A Multi-Institutional Cohort...

Area of Science:

• Oncology
• Dermatology
• Immunology

Background:

• The relationship between pre-existing inflammatory diseases (pIDs) and cutaneous immune-related adverse events (cirAEs) following immune-checkpoint inhibitor (ICI) therapy is not well-established.
• This study investigates the association between various types of pIDs and the incidence, severity, and timing of cirAEs in ICI recipients.

Approach:

• Retrospective review of electronic health records for 3607 ICI recipients at Mass General Brigham.
• Utilized International Classification of Diseases (ICD) codes to identify patients with pIDs.
• Employed Cox proportional hazard, logistic regression, and linear regression models to analyze associations.

Key Points:

• Patients with cutaneous pIDs (HR: 1.56) or both cutaneous and non-cutaneous pIDs (HR: 1.76) exhibited significantly increased risk of developing cirAEs compared to those with non-cutaneous pIDs alone.
• Cutaneous pIDs were also associated with increased cirAE severity (OR: 1.55) and earlier onset (98 days vs. 146 days).
• These findings highlight the heightened vulnerability of patients with specific inflammatory conditions to skin toxicities from ICI treatment.

Conclusions:

• Immune-checkpoint inhibitor recipients with pre-existing inflammatory diseases, particularly those affecting the skin, are at a higher risk for developing, experiencing more severe, and earlier onset of cutaneous immune-related adverse events.
• Enhanced clinical surveillance is warranted for ICI patients with cutaneous pIDs to proactively manage potential skin toxicities.