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Updated: Jun 25, 2026
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Published on: February 10, 2023
The Long-Term Sequelae and Clinical Workload Resulting from Toxicities of Immune Checkpoint Inhibitor (ICI) Therapy
Veera Nurmela1, Anni Juntunen2, Satu Tiainen1,3,4
1Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, PL 1627, Yliopistonranta 8, 70210, Kuopio, Finland.
Background:
Up to half of cancer patients treated with immune checkpoint inhibitors (ICIs) develop immune-related adverse events (irAEs). However, the long-term consequences of irAEs remain poorly characterized.
Objective:
This study investigated the likelihood of chronic irAEs, challenges related to their corticosteroid treatment and clinical workload associated with their management.
Methods:
We retrospectively analyzed 230 patients who received ICIs at Kuopio University Hospital, Finland, between the years 2015 and 2024.
Results:
IrAEs were chronic in 60.9% of patients who developed toxicities. Thyroiditis was the most common chronic AE (40%). Of the patients with irAE+, 42.9% were treated with systemic corticosteroids and steroid-related AEs were observed in 58% of them. Corticosteroid usage for ≥ 3 months was associated with an increased risk of steroid-related AEs (< 3 months 38.2% vs ≥ 3 months 78.8%, p < 0.001). An average of 5.3 contacts with a medical oncologist was needed for the management of an irAE, with the highest workload associated with hepatitis (10.0 contacts/irAE) and colitis (6.1 contacts/irAE).
Conclusions:
The characterization of the long-term sequelae of irAEs and the associated clinical workload is crucial for proper patient education and clinical resource planning.
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