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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Co-Occurring Infections in Cancer Patients Treated with Checkpoint Inhibitors Significantly Increase the Risk of

Siranuysh Grabska1,2, Hovakim Grabski1,2, Tigran Makunts1

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Immune checkpoint inhibitors treat cancer by reactivating T cells but can cause immune-related adverse events (irAEs). This study found a link between these irAEs and infections in patients receiving these cancer therapies.

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atezolizumabcancercolitisdurvalumabimmune checkpoint inhibitorsinfectionipilimumabmyocarditisnivolumabpembrolizumab

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Area of Science:

  • Oncology
  • Immunology
  • Pharmacovigilance

Background:

  • Immune checkpoint inhibitors (ICIs) target immune checkpoints to treat various cancers by reactivating cytotoxic T cells.
  • While effective, ICIs are associated with immune-related adverse events (irAEs) such as pneumonitis, colitis, and hepatitis, which can be severe and even fatal.

Purpose of the Study:

  • To investigate the association between immune-related adverse events (irAEs) and concurrent infectious diseases in patients treated with immune checkpoint inhibitors (ICIs).

Main Methods:

  • Analysis of over 19 million adverse event reports from the FDA's MedWatch database, focusing on 80,000+ reports from patients treated with seven specific ICIs.
  • Statistical analysis to identify significant associations between irAEs and infectious diseases across different ICI agents and classes.

Main Results:

  • A statistically significant association between irAEs and concurrent infectious diseases was identified for five out of seven investigated immune checkpoint inhibitors.
  • This association trend was consistent across all three types of checkpoint inhibitors and five individual therapeutic agents, despite variations in confidence intervals due to record numbers.

Conclusions:

  • Concurrent infectious diseases may be significantly associated with the development of immune-related adverse events in patients undergoing treatment with immune checkpoint inhibitors.
  • Further research is warranted to elucidate the mechanisms underlying this association and inform clinical management strategies.