Risk of Serious Immune-Related Adverse Events with Various PD1 and PD-L1 Inhibitors: A Single-Institution, Real-Life,...

Area of Science:

• Oncology
• Immunology
• Pharmacology

Background:

• Immune checkpoint inhibitors (ICIs) are crucial in cancer therapy but can cause immune-related adverse events (irAEs).
• The specific molecule used for ICIs may influence the frequency and severity of irAEs, a factor not yet fully elucidated.
• Understanding these differences is vital for optimizing patient safety in real-world clinical settings.

Purpose of the Study:

• To compare the safety profiles of different programmed cell death-1 (anti-PD1) and programmed cell death ligand-1 (anti-PD-L1) inhibitors.
• To identify potential predictive biomarkers for severe irAEs associated with these immunotherapies.
• To analyze the impact of irAEs on overall survival and cancer progression.

Main Methods:

• Retrospective analysis of 406 patients treated with anti-PD1 or anti-PD-L1 agents.
• Recording of severe irAEs (grade ≥3) and their characteristics.
• Statistical analysis to identify predictive factors for irAEs and overall survival, focusing on ICI type.

Main Results:

• No significant difference in severe irAEs between anti-PD1 and anti-PD-L1 categories overall (13.7% vs 11.7%).
• Significant variations in severe irAE rates were observed among specific ICIs (e.g., nivolumab 29.6%, pembrolizumab 8.2%).
• Nivolumab treatment and low polymorphonuclear neutrophil levels were identified as risk factors for severe irAEs.

Conclusions:

• This study reveals distinct toxicity profiles among various PD1/PD-L1 inhibitors in real-world use.
• Specific ICIs, such as nivolumab, are associated with a higher risk of severe irAEs.
• Identification of predictive biomarkers like neutrophil levels could aid in personalized immunotherapy strategies.