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Identification of risk factors for gastrointestinal immune-related adverse events associated with immune check point
Ryo Morikawa1,2, Kentaro Nitta3, Shuntaro Yasuda3
1Department of Clinical Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Background:
Gastrointestinal (GI) toxicities are among the most common and potentially severe immune-related adverse events (irAEs), and data on risk factors remain limited. This study aimed to identify risk factors for GI-irAEs in patients treated with ICIs.
Research Design And Methods:
We conducted a retrospective analysis of patients with any type of malignant tumor who received ICIs between January 2020 and January 2022. GI-irAEs were defined as the onset of diarrhea during the observation period. Univariate analysis was employed to explore associations between GI-irAEs and patient characteristics.
Results:
Of the 485 patients screened, 361 were eligible for analysis. GI-irAEs occurred in 29 patients (8.03%). Patients with GI cancer demonstrated shorter event-free survival (EFS) compared to those with non-GI cancer (2.33, 95% CI: 1.03-4.95; p = 0.0275). Additionally, ≥ grade 2 GI-irAEs were observed in 14 patients (3.88%). Patients with GU cancer had a significantly higher incidence of GI-irAEs (odds ratio: 3.26, 95%CI 1.21-8.71, p = 0.0497) and exhibited shorter EFS (hazard ratio: 3.07, 95%CI: 1.05-8.96; p = 0.0273) compared to those with non-GU cancer.
Conclusion:
Our findings suggest that GI cancer may be a risk factor for developing GI-irAEs, while GU cancer may predispose patients to ≥ grade 2 GI-irAEs.
Insights
Gastrointestinal (GI) cancers may increase the risk of developing GI immune-related adverse events (irAEs) from immunotherapy. Genitourinary (GU) cancers are linked to more severe GI-irAEs, impacting survival outcomes.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Gastrointestinal (GI) toxicities are common and severe immune-related adverse events (irAEs) associated with immune checkpoint inhibitors (ICIs).
- Limited data exists on risk factors for GI-irAEs in patients receiving ICIs.
Purpose of the Study:
- To identify risk factors for GI-irAEs in patients treated with ICIs.
- To investigate the association between specific cancer types and the incidence and severity of GI-irAEs.
Main Methods:
- Retrospective analysis of 361 patients with various malignant tumors treated with ICIs between January 2020 and January 2022.
- GI-irAEs defined as diarrhea onset; univariate analysis used to explore associations with patient characteristics.
- Event-free survival (EFS) analyzed in relation to cancer type and GI-irAEs.
Main Results:
- GI-irAEs occurred in 8.03% of patients; 3.88% experienced ≥ grade 2 GI-irAEs.
- Patients with GI cancer had shorter EFS compared to non-GI cancer patients (p=0.0275).
- Patients with Genitourinary (GU) cancer showed a higher incidence of GI-irAEs (OR=3.26, p=0.0497) and shorter EFS (HR=3.07, p=0.0273) compared to non-GU cancer patients.
Conclusions:
- GI cancer may be a risk factor for developing GI-irAEs.
- GU cancer may predispose patients to more severe (≥ grade 2) GI-irAEs.
- Identifying these risk factors can inform clinical management of ICI-related toxicities.
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