Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response
<b>Background:</b> Immune-related adverse events (irAEs) challenge the use of immune checkpoint inhibitors (ICIs). We performed a retrospective study to evaluate response to infliximab for immune-related adverse event management, and infliximab’s effect on progression-free survival (PFS)...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/21/5181 |
| _version_ | 1797632163443638272 |
|---|---|
| author | Vishnupriyadevi Parvathareddy Umut Selamet Aditi A. Sen Omar Mamlouk Juhee Song Valda D. Page Maen Abdelrahim Adi Diab Noha Abdel-Wahab Ala Abudayyeh |
| author_facet | Vishnupriyadevi Parvathareddy Umut Selamet Aditi A. Sen Omar Mamlouk Juhee Song Valda D. Page Maen Abdelrahim Adi Diab Noha Abdel-Wahab Ala Abudayyeh |
| author_sort | Vishnupriyadevi Parvathareddy |
| collection | DOAJ |
| description | <b>Background:</b> Immune-related adverse events (irAEs) challenge the use of immune checkpoint inhibitors (ICIs). We performed a retrospective study to evaluate response to infliximab for immune-related adverse event management, and infliximab’s effect on progression-free survival (PFS) and overall survival (OS) with a focus on melanoma and genitourinary cancers. <b>Methods:</b> We retrospectively reviewed records of all cancer patients exposed to infliximab after immune checkpoint inhibitor (ICI) treatment from 2004 to 2021 at the MD Anderson Cancer Center. Survival was assessed utilizing the Kaplan–Meier method. Univariate and multivariate logistic regression was utilized to evaluate predictors of infliximab response, OS, and PFS. <b>Results:</b> We identified 185 cancer patients (93 melanoma and 37 genitourinary cancers) treated with ICI and who received infliximab to treat irAEs. Within 3 months of treatment initiation, 71% of the patients responded to infliximab, 27% had no response, and 2% had unknown response. Among different irAEs, colitis was associated with increased response to infliximab at 3 months, irrespective of the type of malignancy. We evaluated best tumor response before and after infliximab in the entire cohort and again in the melanoma and genitourinary (GU); the findings were similar in the melanoma cohort and the entire cohort, where best tumor response before and after infliximab was not significantly different. In the melanoma cohort, acute kidney injury (AKI) was associated with increased risk of death, <i>p</i> = 0.0109, and having response to infliximab was associated with decreased risk of death, <i>p</i> = 0.0383. Interestingly in GU cancer patients, myositis was associated with increased risk of death, <i>p</i> = 0.0041, and having a response to infliximab was marginally associated with decreased risk of death, <i>p</i> = 0.0992. As regards PFS, in a multivariate Cox regression model, having a history of cardiovascular disease remained significantly associated with shorter PFS in the melanoma cohort. For patients with GU cancers, response to infliximab was associated with longer PFS. <b>Conclusions:</b> Our study is among the largest retrospective analyses of infliximab use for irAE management. Patients with colitis were the best responders to infliximab. AKI before initiation of infliximab in the melanoma subcohort and myositis in GU subcohort are associated with higher risk of death. Our results indicate no association between infliximab and cancer progression with the exception of genitourinary cancers. |
| first_indexed | 2024-03-11T11:33:01Z |
| format | Article |
| id | doaj.art-c9b625fa8c6c420f86b9bc1193e9a875 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T11:33:01Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c9b625fa8c6c420f86b9bc1193e9a8752023-11-10T15:00:09ZengMDPI AGCancers2072-66942023-10-011521518110.3390/cancers15215181Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor ResponseVishnupriyadevi Parvathareddy0Umut Selamet1Aditi A. Sen2Omar Mamlouk3Juhee Song4Valda D. Page5Maen Abdelrahim6Adi Diab7Noha Abdel-Wahab8Ala Abudayyeh9Department of Nephrology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USADepartment of Nephrology, Baylor College of Medicine, Houston, TX 77030, USASection of Nephrology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Unit 1468, 1400 Pressler Street, Houston, TX 77030, USADepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USASection of Nephrology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Unit 1468, 1400 Pressler Street, Houston, TX 77030, USAInstitute of Academic Medicine and Weill Cornell Medical College, Houston Methodist Cancer Center, Houston, TX 77479, USADepartment of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USADepartment of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USASection of Nephrology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Unit 1468, 1400 Pressler Street, Houston, TX 77030, USA<b>Background:</b> Immune-related adverse events (irAEs) challenge the use of immune checkpoint inhibitors (ICIs). We performed a retrospective study to evaluate response to infliximab for immune-related adverse event management, and infliximab’s effect on progression-free survival (PFS) and overall survival (OS) with a focus on melanoma and genitourinary cancers. <b>Methods:</b> We retrospectively reviewed records of all cancer patients exposed to infliximab after immune checkpoint inhibitor (ICI) treatment from 2004 to 2021 at the MD Anderson Cancer Center. Survival was assessed utilizing the Kaplan–Meier method. Univariate and multivariate logistic regression was utilized to evaluate predictors of infliximab response, OS, and PFS. <b>Results:</b> We identified 185 cancer patients (93 melanoma and 37 genitourinary cancers) treated with ICI and who received infliximab to treat irAEs. Within 3 months of treatment initiation, 71% of the patients responded to infliximab, 27% had no response, and 2% had unknown response. Among different irAEs, colitis was associated with increased response to infliximab at 3 months, irrespective of the type of malignancy. We evaluated best tumor response before and after infliximab in the entire cohort and again in the melanoma and genitourinary (GU); the findings were similar in the melanoma cohort and the entire cohort, where best tumor response before and after infliximab was not significantly different. In the melanoma cohort, acute kidney injury (AKI) was associated with increased risk of death, <i>p</i> = 0.0109, and having response to infliximab was associated with decreased risk of death, <i>p</i> = 0.0383. Interestingly in GU cancer patients, myositis was associated with increased risk of death, <i>p</i> = 0.0041, and having a response to infliximab was marginally associated with decreased risk of death, <i>p</i> = 0.0992. As regards PFS, in a multivariate Cox regression model, having a history of cardiovascular disease remained significantly associated with shorter PFS in the melanoma cohort. For patients with GU cancers, response to infliximab was associated with longer PFS. <b>Conclusions:</b> Our study is among the largest retrospective analyses of infliximab use for irAE management. Patients with colitis were the best responders to infliximab. AKI before initiation of infliximab in the melanoma subcohort and myositis in GU subcohort are associated with higher risk of death. Our results indicate no association between infliximab and cancer progression with the exception of genitourinary cancers.https://www.mdpi.com/2072-6694/15/21/5181acute kidney injuryimmune checkpoint inhibitorcancer progression |
| spellingShingle | Vishnupriyadevi Parvathareddy Umut Selamet Aditi A. Sen Omar Mamlouk Juhee Song Valda D. Page Maen Abdelrahim Adi Diab Noha Abdel-Wahab Ala Abudayyeh Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response Cancers acute kidney injury immune checkpoint inhibitor cancer progression |
| title | Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response |
| title_full | Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response |
| title_fullStr | Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response |
| title_full_unstemmed | Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response |
| title_short | Infliximab for Treatment of Immune Adverse Events and Its Impact on Tumor Response |
| title_sort | infliximab for treatment of immune adverse events and its impact on tumor response |
| topic | acute kidney injury immune checkpoint inhibitor cancer progression |
| url | https://www.mdpi.com/2072-6694/15/21/5181 |
| work_keys_str_mv | AT vishnupriyadeviparvathareddy infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT umutselamet infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT aditiasen infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT omarmamlouk infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT juheesong infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT valdadpage infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT maenabdelrahim infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT adidiab infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT nohaabdelwahab infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse AT alaabudayyeh infliximabfortreatmentofimmuneadverseeventsanditsimpactontumorresponse |