Patterns and prognostic significance of cutaneous immune-related adverse events in non–small cell lung cancer

Thompson, Leah L.; Nadelmann, Emily R.; Blum, Amy E.; Yoon, Jaewon; Polyakov, Nicole J.; Kagan, Ruth; Gainor, Justin F.; Mooradian, Meghan J.; Chen, Steven T

doi:10.1016/j.ejca.2021.01.022

Cited by 5 publications

(12 citation statements)

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“…Our meta-analysis of OS included 16 trials, and an association between cirAE occurrence and longer OS (HR, 0.61 [95% CI, 0.52-0.72]; I 2 = 70.7%; P < .001) was observed (Figure 2A). The meta-analysis of PFS included 12 articles, and we observed that patients who experienced cirAEs after ICI treatment had better PFS than those who did not (HR, 0.52 [95% CI, 0.41-0.65]; I 2 = 45.1%; P < .001) (Figure 2B).…”

Section: Resultsmentioning

confidence: 93%

“…A total of 7 studies included only OS data, 3 studies provided only PFS data, and 13 studies provided both OS and PFS data . In terms of ICI type, most eligible studies focused on PD-1 inhibitors and/or PD-L1 inhibitors; only 2 studies examined CTLA-4 inhibitors . With regard to geographic region, 8 studies were conducted in Asia-Pacific countries, 8 in European countries, and 7 in the US .…”

Section: Resultsmentioning

confidence: 99%

“…Two additional studies were discovered through a search of the citations of relevant studies. The meta-analysis comprised 23 articles that satisfied the established criteria, involving a total of 22 749 patients …”

Section: Resultsmentioning

confidence: 99%

“…The eTable in Supplement 1 provides an overview of the study characteristics. The majority of studies (n = 21) were retrospective, whereas 2 were prospective and 1 was a randomized clinical trial . All included studies examined the association between cirAE development and cancer prognosis.…”

Section: Resultsmentioning

confidence: 99%

“…All included studies examined the association between cirAE development and cancer prognosis. A total of 7 studies included only OS data, 3 studies provided only PFS data, and 13 studies provided both OS and PFS data . In terms of ICI type, most eligible studies focused on PD-1 inhibitors and/or PD-L1 inhibitors; only 2 studies examined CTLA-4 inhibitors .…”

Section: Resultsmentioning

confidence: 99%

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Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Du,

Wu,

Chen

et al. 2023

JAMA Dermatol

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ImportanceGrowing research suggests that the prevalence of cutaneous immune-related adverse events (cirAEs) is associated with favorable outcomes among individuals with cancer who receive immune checkpoint inhibitor (ICI) treatment.ObjectiveTo identify whether the presence of cirAEs and their subtypes subsequent to ICI administration is associated with enhanced cancer prognosis.Data SourcesThe PubMed, Embase, Cochrane Library, and Web of Science databases were searched for publications examining the association between cirAE development during ICI treatment and subsequent cancer prognosis. The initial search was limited to English-language publications from database inception until December 31, 2022; a subsequent search was performed on May 21, 2023.Study SelectionTwo reviewers independently scrutinized the identical articles and included those that constituted original research evaluating the association between cirAE development and cancer prognosis.Data Extraction and SynthesisThe search terms, study objectives, and methodological protocols were defined before study initiation. The aforementioned 2 reviewers performed data extraction independently and resolved discrepancies through agreement. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis and the Meta-analysis of Observational Studies in Epidemiology reporting guidelines. The protocol was prospectively registered with PROSPERO. Data analyses were conducted between May 21 and June 1, 2023.Main Outcomes and MeasuresThe major outcome end points were overall survival (OS) and progression-free survival (PFS). Subgroup analyses were also conducted according to cirAE type, cancer type, geographic region, study design, and ICI type. Given the heterogeneity inherent in the included studies, a DerSimonian-Laird random-effects model was adopted.ResultsThis systematic review and meta-analysis included 23 studies with a total of 22 749 patients treated with ICIs. The occurrence of cirAEs was associated with improved OS (hazard ratio [HR], 0.61 [95% CI, 0.52-0.72]; P &lt; .001) and PFS (HR, 0.52 [95% CI, 0.41-0.65]; P &lt; .001). Consistent results were observed across all subgroups stratified by study design, geographic region, ICI type, and cancer type, aligning with the overall estimate of OS and PFS improvement. However, no statistically significant differences were identified in terms of PFS within studies conducted in the US.Conclusions and RelevanceIn this systematic review and meta-analysis, the presence of cirAEs and their subtypes was associated with improved prognosis for individuals with cancer undergoing ICI treatment. These findings suggest that cirAEs may have useful prognostic value in ICI treatment.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Du,

Wu,

Chen

et al. 2023

JAMA Dermatol

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Diagnostic accuracy of general dermatologists and supportive oncodermatologists for biopsied cutaneous immune-related adverse events

Thompson

Said

et al. 2022

Support Care Cancer

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Rare Immune-Related Adverse Events (irAEs): Approach to Diagnosis and Management

Javaid,

Bennett,

Rao

et al. 2024

Pharm Med

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Immune checkpoint inhibitors (ICIs) have revolutionised the treatment landscape across many solid organ malignancies and form part of routine clinical practice in many tumours. As indications for monotherapy, doublet therapy and combination approaches with chemotherapy and targeted agents expand, clinicians must be aware of the wide range of possible immune-related adverse events (irAEs). Common toxicities, including rash, colitis, hepatitis and pneumonitis are well described in the literature, and have established diagnostic and management algorithms. Rarer toxicities, often with an incidence of less than 1%, are less defined. These syndromes can be poorly recognised, may take on a fulminant course and do not have established or evidence-based diagnostic and management strategies. As such, patients may experience increased morbidity, mortality and poorer outcomes, related both to these irAEs as well as how the treatment of these may affect the management of their underlying malignancy. In this review, we aim to explore the incidence, potential biomarkers, pathogenesis, diagnostic work-up and clinical sequelae of a selection of uncommon irAEs, with a focus on myocarditis, neurological and haematologic syndromes. Further prospective research is required to accurately define the incidence and pathogenesis of these conditions, with the aim of increasing clinician awareness of rare irAEs and to assist with a more personalised and mechanism-based approach to these syndromes.

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Patterns and prognostic significance of cutaneous immune-related adverse events in non–small cell lung cancer

Cited by 5 publications

References 5 publications

Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Diagnostic accuracy of general dermatologists and supportive oncodermatologists for biopsied cutaneous immune-related adverse events

Rare Immune-Related Adverse Events (irAEs): Approach to Diagnosis and Management

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