Prevalence of PD-1 Inhibitor-Associated Peripheral Neuropathy: A Retrospective Cohort Study

Immunotherapy is a promising treatment option for many cancers but is associated with the development of peripheral neuropathy in some patients. This retrospective cross-sectional EMR-based prevalence study was performed at MD Anderson Cancer Center with an aim to define the prevalence and epidemiology of Programmed Cell Death Protein 1 (PD-1) inhibitor-associated polyneuropathy. A total of 12,092 patients treated with a PD-1 inhibitor between 4 March 2016 and 18 June 2023 were identified and those on immunotherapy monotherapy were isolated. A total of 817 patients had documented neuropathy-associated with PD-1 inhibitor exposure, corresponding to a prevalence of 6.76% (6.76%, 95% CI 6.31-7.22). Data was stratified to assess for association between peripheral neuropathy and agent, sex, race, ethnicity, smoking and diabetes status. Patients identifying as "Other" race had higher prevalence of neuropathy compared to White or Caucasian patients (OR 1.514, p = 0.0189) and non-Hispanic or Latino patients had higher prevalence of neuropathy compared to Hispanic or Latino patients (OR 1.502, p = 0.0078). Current-smokers had significantly lower prevalence of neuropathy compared to never-smokers (OR 0.716, p = 0.0368). These disparities underscore the importance of further investigation in genetics and mechanisms to identify therapeutic interventions for PD-1 inhibitor-associated peripheral neuropathy.