Immune-related adverse events of anti-PD-1 immune checkpoint inhibitors: a single center experience

Frontiers in Oncology

Oncology

Zsuzsanna Orosz¹  Attila Vaskó¹  Attila Makai¹  Gábor Tóth²  Nóra Major³  Éva Szekanecz³  Ingrid Balogh³  Enikő Sebestyén³  Péter Árkosy³  Zoltán Szekanecz⁴  Levente Bodoki⁴  Katalin Hodosi⁴ 

[1] Department Pulmonology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary;Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary;Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary;Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary;

关键词: immune-checkpoint inhibitors;    immune-related adverse events;    anti-PD-1;    nivolumab;    pembrolizumab;    Central-Eastern Europe;    Hungary;   

DOI  :  10.3389/fonc.2023.1252215

 received in 2023-07-03, accepted in 2023-10-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesImmune checkpoint inhibitors (ICIs) stimulate antitumor immune responses and, in parallel, they might trigger autoimmune and other immunopathological mechanisms eventually leading to immune-related adverse events (irAE). In our study, we assessed patients with malignancies who underwent anti-PD-1 treatment at the University of Debrecen, Clinical Center.Patients and methodsBetween June 2017 and May 2021, 207 patients started ICI treatment at our university. A total of 157 patients received nivolumab and 50 were treated with pembrolizumab. We looked for factors associated with the development of irAEs. In addition to correlation studies, we performed binary logistic regression analysis to determine, which factors were associated with irAEs. We also performed Forward Likelihood Ratio (LR) analysis to determine independent prognostic factors.ResultsAt the time of data analysis, the mean duration of treatment was 2.03 ± 0.69 years. ROC analysis determined that 9 or more treatment cycles were associated with a significantly higher risk of irAEs. A total of 125 patients received ≥9 treatment cycles. Three times more patients were treated with nivolumab than pembrolizumab. Of the 207 patients, 66 (32%) developed irAEs. Among the 66 patients who developed irAEs, 36 patients (55%) developed one, 23 (35%) developed two, while 7 (10%) developed three irAEs in the same patient. The most common irAEs were thyroid (33 cases), dermatological (25 cases), pneumonia (14 cases) and gastrointestinal complications (13 cases). Patients who developed irAEs received significantly more treatment cycles (21.8 ± 18.7 versus 15.8 ± 17.4; p=0.002) and were younger at the start of treatment (60.7 ± 10.8 versus 63.4 ± 10.1 years; p=0.042) compared to patients without irAEs. Pembrolizumab-treated patients developed more but less severe irAEs compared to those receiving nivolumab.ConclusionICI treatment is very effective, however, irAEs may develop. These irAEs might be related to the number of treatment cycles and the type of treated malignancy.

【 授权许可】

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Copyright © 2023 Sebestyén, Major, Bodoki, Makai, Balogh, Tóth, Orosz, Árkosy, Vaskó, Hodosi, Szekanecz and Szekanecz