Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study
IntroductionCheckpoint inhibitors, such as PD1 inhibitors, represent an important pillar in the therapy of advanced malignancies of the head and neck region. The most relevant complications are immune-related adverse effects (irAEs), which represent an immense burden for patients. Currently, no suff...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1287178/full |
| _version_ | 1797311599985295360 |
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| author | Frederic Jungbauer Annette Affolter Christoph Brochhausen Anne Lammert Sonja Ludwig Kirsten Merx Nicole Rotter Lena Huber |
| author_facet | Frederic Jungbauer Annette Affolter Christoph Brochhausen Anne Lammert Sonja Ludwig Kirsten Merx Nicole Rotter Lena Huber |
| author_sort | Frederic Jungbauer |
| collection | DOAJ |
| description | IntroductionCheckpoint inhibitors, such as PD1 inhibitors, represent an important pillar in the therapy of advanced malignancies of the head and neck region. The most relevant complications are immune-related adverse effects (irAEs), which represent an immense burden for patients. Currently, no sufficient stratification measures are available to identify patients at increased risk of irAEs. The aim of this retrospective study was to examine whether demographic, histopathological, clinical, or laboratory values at the start of CPI therapy represent a risk factor for the later occurrence of autoimmune complications.Material and methodsData from 35 patients between 2018 and 2021 who received therapy with nivolumab or pembrolizumab for head and neck malignancy were analyzed and assessed for any associations with the subsequent occurrence of irAEs.ResultsIrAE developed in 37% of patients, with pneumonitis being the most common form (14%). Pneumonitis was found in patients with an average significantly lower T-stage of primary tumors. An increase in basophilic leukocytes was found in patients with dermatitis later in the course. When thyroiditis developed later, the patients had a higher CPS score and lower monocyte levels.DiscussionEven though individual laboratory values at the beginning of therapy might show a statistical association with the later occurrence of irAEs, neither demographic, histopathological, nor laboratory chemistry values seem to be able to generate a sound and reliable risk profile for this type of complication. Therefore, patients need to be educated and sensitized to irAEs, and regular screening for irAEs should be carried out. |
| first_indexed | 2024-03-08T02:03:00Z |
| format | Article |
| id | doaj.art-a9671283f38448478180547515e7c6e1 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T02:03:00Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a9671283f38448478180547515e7c6e12024-02-14T05:01:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-02-011410.3389/fonc.2024.12871781287178Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center studyFrederic Jungbauer0Annette Affolter1Christoph Brochhausen2Anne Lammert3Sonja Ludwig4Kirsten Merx5Nicole Rotter6Lena Huber7Department of Otorhinolaryngology, Head- and Neck-Surgery, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Otorhinolaryngology, Head- and Neck-Surgery, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Pathology, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Otorhinolaryngology, Head- and Neck-Surgery, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Otorhinolaryngology, Head- and Neck-Surgery, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Otorhinolaryngology, Head- and Neck-Surgery, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Otorhinolaryngology, Head- and Neck-Surgery, University Medical Centre Mannheim, Heidelberg University, Mannheim, GermanyIntroductionCheckpoint inhibitors, such as PD1 inhibitors, represent an important pillar in the therapy of advanced malignancies of the head and neck region. The most relevant complications are immune-related adverse effects (irAEs), which represent an immense burden for patients. Currently, no sufficient stratification measures are available to identify patients at increased risk of irAEs. The aim of this retrospective study was to examine whether demographic, histopathological, clinical, or laboratory values at the start of CPI therapy represent a risk factor for the later occurrence of autoimmune complications.Material and methodsData from 35 patients between 2018 and 2021 who received therapy with nivolumab or pembrolizumab for head and neck malignancy were analyzed and assessed for any associations with the subsequent occurrence of irAEs.ResultsIrAE developed in 37% of patients, with pneumonitis being the most common form (14%). Pneumonitis was found in patients with an average significantly lower T-stage of primary tumors. An increase in basophilic leukocytes was found in patients with dermatitis later in the course. When thyroiditis developed later, the patients had a higher CPS score and lower monocyte levels.DiscussionEven though individual laboratory values at the beginning of therapy might show a statistical association with the later occurrence of irAEs, neither demographic, histopathological, nor laboratory chemistry values seem to be able to generate a sound and reliable risk profile for this type of complication. Therefore, patients need to be educated and sensitized to irAEs, and regular screening for irAEs should be carried out.https://www.frontiersin.org/articles/10.3389/fonc.2024.1287178/fullHNSCC (head and neck squamous cell carcinoma)HNC (head and neck cancer)checkpoint inhibitionirAEirAE diagnostic approachPD-L1 |
| spellingShingle | Frederic Jungbauer Annette Affolter Christoph Brochhausen Anne Lammert Sonja Ludwig Kirsten Merx Nicole Rotter Lena Huber Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study Frontiers in Oncology HNSCC (head and neck squamous cell carcinoma) HNC (head and neck cancer) checkpoint inhibition irAE irAE diagnostic approach PD-L1 |
| title | Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study |
| title_full | Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study |
| title_fullStr | Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study |
| title_full_unstemmed | Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study |
| title_short | Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study |
| title_sort | risk factors for immune related adverse effects during cpi therapy in patients with head and neck malignancies a single center study |
| topic | HNSCC (head and neck squamous cell carcinoma) HNC (head and neck cancer) checkpoint inhibition irAE irAE diagnostic approach PD-L1 |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1287178/full |
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