Delayed immune-related adverse events in long-responders of immunotherapy: a single-center experience

IF 1.4 4区医学 Q4 ONCOLOGY Asia-Pacific journal of clinical oncology Pub Date : 2024-04-12 DOI:10.1111/ajco.14059

Masatake Kitano, Takayuki Honda, Eri Hikita, Masahiro Masuo, Yasunari Miyazaki, Masayoshi Kobayashi

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Abstract

Background

Immune-checkpoint inhibitors (ICIs) often cause immune-related adverse events (irAEs). The spectrum of irAEs and their managements has been partially clarified, however the knowledge on time-course of irAEs is not well understood.

Methods

A retrospective study based on the medical record was performed. The study subjects were consisting of patients with various types of solid tumors for whom ICIs (nivolumab, pembrolizumab, durvalumab, atezolizumab, nivolumab plus ipilimumab) were used between April 2016 and October 2021. We focused on irAEs developed more than 1-year after commencement ICIs (delayed irAE group) and compared with irAEs developed within 1-year (non-delayed irAE group) in terms of types and severity of irAEs.

Results

A total of 336 patients were enrolled in the study. Eighty-eight patients (26.2%) developed irAEs and 248 did not. Most of the patients developing irAEs were treated using PD-L1/PD-1 inhibitors. Eighty-one patients (24.1%) in non-delayed irAE group and 7 patients (2.1%) in delayed irAE group developed irAEs. The median onset of irAEs in the delayed irAE group was 18.6 months (range: 13.5–24.3). The types of irAEs observed in delayed irAE group were dermatitis (2 cases), pneumonitis (2 cases), nephritis (1 case), arthritis (1 case), and gastritis (1 case). The severity of irAEs was almost mild (≤G2), but one patient (.3%) developed G3 nephritis.

Conclusion

PD-L1/PD-1 inhibitors frequently caused various irAEs but their severities were mostly tolerable. Few patients developed delayed irAE with mild toxities.

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免疫疗法长期应答者的延迟免疫相关不良事件：单中心经验

背景免疫检查点抑制剂（ICIs）经常引起免疫相关不良事件（irAEs）。目前已部分明确了irAEs的范围及其处理方法，但对irAEs的时间过程还不甚了解。研究对象包括在2016年4月至2021年10月期间使用过ICIs（nivolumab、pembrolizumab、durvalumab、atezolizumab、nivolumab加ipilimumab）的各类实体瘤患者。我们重点研究了开始使用 ICIs 超过 1 年后出现的虹膜睫状体异常（延迟虹膜睫状体异常组），并就虹膜睫状体异常的类型和严重程度与 1 年内出现的虹膜睫状体异常（非延迟虹膜睫状体异常组）进行了比较。88名患者（26.2%）出现了虹膜后遗症，248名患者没有出现。大多数出现虹膜刺激症状的患者接受了PD-L1/PD-1抑制剂治疗。非延迟irAE组有81名患者（24.1%）出现irAE，延迟irAE组有7名患者（2.1%）出现irAE。延迟虹膜睫状体放电组虹膜睫状体放电的中位发病时间为 18.6 个月（范围：13.5-24.3）。延迟虹膜AE组观察到的虹膜AE类型为皮炎（2例）、肺炎（2例）、肾炎（1例）、关节炎（1例）和胃炎（1例）。结论PD-L1/PD-1抑制剂经常引起各种虹膜睫状体反应，但其严重程度大多可以耐受。少数患者出现了轻微毒性的延迟性虹膜AE。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.