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

BMC Cancer

Chan-Keng Yang¹  Pei-Wei Huang¹  Chiao-En Wu¹  John Wen-Cheng Chang¹  Meng-Ting Peng¹  Ching-Fu Chang¹  Chun-Bing Chen²  Chao-Wei Hsu³  Gigin Lin⁴  Cheng-Tao Lin⁵  Shir-Hwa Ueng⁶  Chi-Yuan Cheng⁷  Chih-Liang Wang⁸  I-Wen Chen⁹  Yu-Fen Lin^1,10  Kun-Yun Yeh^1,11 

[1] Division of Haematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan;Chang Gung University College of Medicine, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Dermatology, Chang Gung Memorial Hospital at Linkou, Taipei, Keelung, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Medical Imaging & Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Obstetrics and Gynecology, , Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Pathology, Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Pharmacy, , Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan;Immuno-Oncology Center of Excellence, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;

关键词: Immune checkpoint inhibitors;    irAE;    Skin toxicity;    Vitiligo;    Endocrine;    Melanoma;    PD-1;   

DOI  :  10.1186/s12885-020-07508-7

来源: Springer

【 摘 要 】

BackgroundThe association between immune-related adverse events (irAEs) and survival outcomes in patients with advanced melanoma receiving therapy with immune checkpoint inhibitors (ICIs) has not been well established, particularly in Asian melanoma.MethodsWe retrospectively reviewed 49 melanoma patients undergoing therapy with ICIs (anti-PD-1 monotherapy), and analyzed the correlation between irAEs and clinical outcomes including progression-free survival (PFS) and overall survival (OS). Results: Overall, the patients who experienced grade 1–2 irAEs had longer PFS (median PFS, 4.6 vs. 2.5 months; HR, 0.52; 95% CI: 0.27–0.98; p = 0.042) and OS (median OS, 15.2 vs. 5.7 months; HR, 0.50; 95% CI: 0.24–1.02; p = 0.058) than the patients who did not experience irAEs. Regarding the type of irAE, the patients with either skin/vitiligo or endocrine irAEs showed better PFS (median PFS, 6.1 vs. 2.7 months; HR, 0.40, 95% CI: 0.21–0.74; p = 0.003) and OS (median OS, 18.7 vs. 4.5 months; HR, 0.34, 95% CI: 0.17–0.69, p = 0.003) than patients without any of these irAEs.ConclusionsMelanoma patients undergoing anti-PD-1 monotherapy and experiencing mild-to-moderate irAEs (grade 1–2), particularly skin (vitiligo)/endocrine irAEs had favorable survival outcomes. Therefore, the association between irAEs and the clinical outcomes in melanoma patients undergoing anti-PD-1 ICIs may be severity and type dependent.

【 授权许可】

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