The association between immune-related adverse events and survival outcomes in Asian patients with advanced melanoma receiving anti-PD-1 antibodies

Wu, Chiao‐En; Yang, Chih–Kai; Peng, Meng-Ting; Huang, Pei-Wei; Chang, Ching‐Fu; Yeh, Kun‐Yun; Chen, Chun‐Bing; Wang, Chih‐Liang; Hsu, Chao‐Wei; Chen, I‐Wen; Lin, Cheng-Tao; Ueng, Shir-Hwa; Lin, Gigin; Lin, Yu-Fen; Cheng, Ching‐Yi; Chang, John Wen‐Cheng

doi:10.1186/s12885-020-07508-7

Cited by 26 publications

(38 citation statements)

References 41 publications

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“…The reason is related to the initial time of irAEs. Studies have shown that most irAEs appear within 3 months after the beginning of treatment, while serious adverse reactions such as immune associated pneumonia appear within two months (27). Combined with our clinical data, some patients terminate treatment early due to severe adverse reactions such as immune-related myocardial injury and immunerelated pneumonia.…”

Section: Discussionsupporting

confidence: 58%

Absolute Eosinophil Count May be One of the Most Optimal Peripheral Blood Markers to Identify Risk of Immune-Related Adverse Events in Advanced Malignant Tumors Treated with PD-1/PD-L1 Inhibitors.

Wang

et al. 2021

Preprint

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Background To investigate the predictive value of serum biomarkers such as AEC、Neutrophil- lymphocyte ratio (NLR) and platelets - lymphocyte ratio(PLR) on immune-related adverse events (irAEs) during the PD-1/PD-L1 inhibitors treatment in advanced malignant tumors. Methods We retrospectively analyzed 95 advanced cancer patients treated with PD-1/PD-L1 inhibitor from January 1, 2017 to May 1, 2020 in our cancer center. Then, the associations between irAEs and PD-1/PD-L1 inhibitors respond was analyzed and the predictive value of serum biomarkers on irAEs occurrence risk was evaluated. Results The incidence of irAEs was 55.8%. There were no statistically significant differences between the irAEs group and the no-irAEs group in Objective response rate (ORR) and Disease control rate (DCR), but the Landmark analysis showed that the irAEs group had better survival after 120 days compared with the no-irAEs group. The incidence of irAEs in the high-AEC and low-NLR groups was greater than that in the low-AEC and high-NLR groups. Univariate logistic analysis results showed that low-NLR, ECOG (0-1) and High-AEC were risk factors for irAEs. However, multivariate logistic analysis not only shows that AEC is an independent factor of irAEs, but also suggests that good ECOG may be more prone to irAEs . Conclusions IrAEs may show a survival benefit to a certain extent. Baseline AEC is a strong predictor of irAEs in the treatment of PD-1/PD-L1 inhibitors.

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Section: Discussionsupporting

confidence: 58%

Absolute Eosinophil Count May be One of the Most Optimal Peripheral Blood Markers to Identify Risk of Immune-Related Adverse Events in Advanced Malignant Tumors Treated with PD-1/PD-L1 Inhibitors.

Wang

et al. 2021

Preprint

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“…Because of the immortal time bias of irAEs and the intersection points in the overall analysis, we used landmark analysis, in which the irAEs group showed a survival advantage after PFS for 120 days. This finding is related to the initial onset of irAEs: most irAEs reportedly appear within 3 months after the initiation of treatment, while serious adverse reactions such as immune-associated pneumonia appear within 2 months [48]. Our clinical data indicated that some patients discontinued treatment early because of severe adverse reactions such as immune-related myocardial injury and immunerelated pneumonitis.…”

Section: Discussionmentioning

confidence: 58%

Absolute eosinophil count may be an optimal peripheral blood marker to identify the risk of immune-related adverse events in advanced malignant tumors treated with PD-1/PD-L1 inhibitors: a retrospective analysis

Wang

et al. 2022

World J Surg Onc

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Background This study aimed to investigate the predictive values of serum biomarkers including absolute eosinophil count (AEC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) with respect to immune-related adverse events (irAEs) during anti-PD-1/PD-L1 inhibitor treatment in patients with advanced malignant tumors. Methods We retrospectively analyzed 95 patients with advanced cancer who were treated with anti-PD-1/PD-L1 inhibitors from January 1, 2017, to May 1, 2020, in our cancer center. We then analyzed associations between irAEs and anti-PD-1/PD-L1 inhibitor responses and evaluated the predictive values of serum biomarkers with respect to the risk of irAEs. Results The incidence of irAEs was 55.8%. There were no statistically significant differences between the irAEs and no-irAEs groups in an objective response rate (ORR) or disease control rate (DCR). However, landmark analysis showed that the irAEs group had better survival after 120 days following the initiation of anti-PD-1/PD-L1 inhibitor treatment, compared with the no-irAEs group. The incidences of irAEs were greater in the high-AEC and low-NLR groups than in the low-AEC and high-NLR groups. Univariate logistic analysis showed that low NLR, ECOG performance status (0–1), and high AEC were risk factors for irAEs. Multivariate logistic analysis showed that high AEC and good ECOG performance status were independent predictors for irAEs. Conclusions irAEs may be associated with a survival benefit. Baseline AEC is a strong predictor of irAEs in patients undergoing treatment with anti-PD-1/PD-L1 inhibitors.

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“…The relationship between skin irAEs and treatment efficacy has also been previously described, mostly in melanoma and NSCLC [ 41 , 45 ]. A meta-analysis of ICI therapy in melanoma found that vitiligo was significantly associated with both longer PFS and OS [ 46 ].…”

Section: Discussionmentioning

confidence: 98%

“…The positive relationship between AEs of the endocrine spectrum and treatment response has been described in a few studies, both analyzed all together or individually as thyroid dysfunction. As above-mentioned, most studies have described a cohort of patients with melanoma [ 41 ] or NSCLC [ 42 ]. Less is known about endocrine irAEs as a prognostic factor in RCC [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Immune Related Adverse Events and Outcome in Patients with Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors

Paderi

Giorgione

Giommoni

et al. 2021

Cancers

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Background: It has been reported that the occurrence of immune-related adverse events (irAEs) in oncological patients treated with immune-checkpoint inhibitors (ICIs) may be associated with favorable clinical outcome. We reported the clinical correlation between irAEs and the efficacy of ICIs in a real-world cohort of metastatic renal cell cancer (mRCC) patients. Methods: We retrospectively evaluated 43 patients with mRCC who were treated with nivolumab or with nivolumab plus ipilimumab. We considered seven specific classes of irAEs including pulmonary, hepatic, gastrointestinal, cutaneous, endocrine, rheumatological, and renal manifestations. We assessed progression-free survival (PFS) of specific irAEs classes compared to the no-irAEs group. Results: Twenty-nine out of 43 patients (67.4%) experienced a total of 49 irAEs registered. The most frequent irAE was thyroid dysfunction (n = 14). The median PFS after the beginning of therapy was significantly longer in patients with thyroid dysfunction and cutaneous reactions. In multivariate analysis, thyroid dysfunction was an independent factor for favorable outcome [HR: 0.29 (95% CI 0.11–0.77) p = 0.013]. Moreover, experiencing ≥2 irAEs in the same patient correlated in multivariate analysis with better outcome compared with none/one irAE [HR: 0.33 (95% CI 0.13–0.84) p = 0.020]. Conclusions: This retrospective study suggests an association between specific irAES (thyroid dysfunction and skin reaction) and efficacy of ICIs in metastatic RCC. Notably, multiple irAEs in a single patient were associated with better tumor response.

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The association between immune-related adverse events and survival outcomes in Asian patients with advanced melanoma receiving anti-PD-1 antibodies

Cited by 26 publications

References 41 publications

Absolute Eosinophil Count May be One of the Most Optimal Peripheral Blood Markers to Identify Risk of Immune-Related Adverse Events in Advanced Malignant Tumors Treated with PD-1/PD-L1 Inhibitors.

Absolute Eosinophil Count May be One of the Most Optimal Peripheral Blood Markers to Identify Risk of Immune-Related Adverse Events in Advanced Malignant Tumors Treated with PD-1/PD-L1 Inhibitors.

Absolute eosinophil count may be an optimal peripheral blood marker to identify the risk of immune-related adverse events in advanced malignant tumors treated with PD-1/PD-L1 inhibitors: a retrospective analysis

Association between Immune Related Adverse Events and Outcome in Patients with Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors

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