Exploring the Dynamics of Immune Checkpoint Inhibitor-Induced Eosinophilia in Advanced/Metastatic Melanoma: A Comprehensive Retrospective Analysis

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-03-27 DOI:10.1002/cam4.70679

Panagiotis T. Diamantopoulos, Aikaterini Gkoufa, Amalia Anastasopoulou, Panagiotis Kouzis, Georgios Lyrarakis, Georgios Kyriakakis, Helen Gogas

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Abstract

Background

Immune-related eosinophilia has emerged as an adverse event associated with immune checkpoint inhibitors (ICIs). Its prevalence, severity, duration, clinical significance, diagnostic approach, and management remain unexplored.

Methods

We conducted a retrospective review of melanoma patient records at a university referral center. Our analysis encompassed the incidence of eosinophilia, baseline disease characteristics, treatment modalities, peak eosinophil counts, associated symptoms, diagnostic procedures, management strategies, disease course, and prognostic implications.

Results

A total of 308 patients were included. Eosinophilia was present in 21.4%, and there was no association with gender, age, histologic type, stage, or BRAF mutation status. The median time interval from treatment initiation to the eosinophilia onset was 56 days, the median eosinophil count at first presentation was 0.70 × 10⁹/L, and the maximum eosinophil count was 1.02 × 10⁹/L. The rate of eosinophilia was significantly higher in patients treated with nivolumab plus bempegaldesleukin (50.0%), followed by nivolumab plus ipilimumab (21.7%). Symptomatic patients and/or patients with hypereosinophilia were assessed for organ involvement and for the identification of the cause of eosinophilia. Patients requiring medical intervention were managed with corticosteroids or antihistamines. Eosinophilia relapsed in 31.8% when rechallenged. While non-significant, there was a numeric trend for longer overall survival in patients with eosinophilia (42.6 vs. 27.9 months, p = 0.178).

Conclusions

This study marks the first comprehensive approach of the relationship between the type of immunotherapy and the incidence of eosinophilia in melanoma patients. It also delves into the patients' baseline characteristics, diagnostic assessment, management, and prognosis, providing useful guidance for physicians treating patients with ICIs.

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探索免疫检查点抑制剂诱导的嗜酸性粒细胞增多在晚期/转移性黑色素瘤中的动态：一项全面的回顾性分析

免疫相关嗜酸性粒细胞增多已成为与免疫检查点抑制剂（ICIs）相关的不良事件。其患病率，严重程度，持续时间，临床意义，诊断方法和管理仍未被探索。方法我们对一所大学转诊中心的黑色素瘤患者记录进行回顾性分析。我们的分析包括嗜酸性粒细胞的发生率、基线疾病特征、治疗方式、嗜酸性粒细胞峰值计数、相关症状、诊断程序、管理策略、病程和预后影响。结果共纳入308例患者。21.4%的患者嗜酸性粒细胞增多，与性别、年龄、组织学类型、分期或BRAF突变状态无关。从开始治疗到嗜酸性粒细胞增多的中位时间间隔为56天，首次出现时嗜酸性粒细胞计数中位数为0.70 × 109/L，最大嗜酸性粒细胞计数为1.02 × 109/L。纳武单抗联合本培galdesleukin治疗的患者嗜酸性粒细胞增多率显著较高（50.0%），其次是纳武单抗联合伊匹单抗（21.7%）。对有症状的患者和/或嗜酸性粒细胞增多的患者进行器官受累和嗜酸性粒细胞增多的病因鉴定。需要医疗干预的患者接受皮质类固醇或抗组胺药治疗。再次挑战嗜酸性粒细胞时复发的占31.8%。虽然无统计学意义，但嗜酸性粒细胞增多患者的总生存期有较长的数字趋势（42.6个月vs 27.9个月，p = 0.178）。本研究首次全面探讨了免疫治疗类型与黑色素瘤患者嗜酸性粒细胞增多症发病率之间的关系。它还深入研究了患者的基线特征，诊断评估，管理和预后，为医生治疗ICIs患者提供有用的指导。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.