Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients
ICI therapy has greatly improved patient outcomes in melanoma, but at the cost of immune-related adverse events (irAEs). Data on the chronicity of irAEs, especially in real-world settings, are currently limited. We performed a retrospective chart review of 161 adult patients with melanoma treated wi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/10/629 |
| _version_ | 1827650775456677888 |
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| author | Justin Tong Adi Kartolo Cynthia Yeung Wilma Hopman Tara Baetz |
| author_facet | Justin Tong Adi Kartolo Cynthia Yeung Wilma Hopman Tara Baetz |
| author_sort | Justin Tong |
| collection | DOAJ |
| description | ICI therapy has greatly improved patient outcomes in melanoma, but at the cost of immune-related adverse events (irAEs). Data on the chronicity of irAEs, especially in real-world settings, are currently limited. We performed a retrospective chart review of 161 adult patients with melanoma treated with at least one cycle of ICI regimen in the adjuvant or metastatic setting: 129 patients received PD-1 inhibitor monotherapy and 32 received dual immunotherapy. Patients were grouped by duration of irAE: permanent (no complete resolution), long-term (resolution over a period ≥ 6 months), transient (resolution over a period < 6 months), or no irAEs. A total of 283 irAEs were reported in the whole patient population. Sixty-six (41.0%) patients developed permanent irAEs, fifteen (9.3%) experienced long-term irAEs as their longest-lasting toxicity, thirty-four (21.1%) developed transient irAEs only, and forty-six (28.6%) experienced no irAEs. Permanent irAEs occurred in 21 (65.6%) patients treated with dual immunotherapy and in 45 (34.9%) patients treated with monotherapy. The majority of permanent irAEs were endocrine-related (36.0%) or skin-related (32.4%). Grade 3–4 permanent irAEs occurred in 20 (12.4%) patients and included toxicities such as adrenal insufficiency, myocarditis, and myelitis. Fifty-three (32.9%) patients were still requiring treatment for long-term or permanent irAEs 6 months or more following the completion of ICI therapy, including twenty-four patients on thyroid hormone replacement and twenty-two on oral steroids. ICI treatment was temporarily interrupted for 64 (22.6%) irAEs and permanently discontinued due to irAEs in 38 patients (13.6% of irAEs, 23.6% of patients); additionally, 4 (2.5%) patients died of irAEs. Our findings show that ICI treatment in melanoma is associated with a wide range of toxicities that can be permanent and may have long-lasting impacts on patients, which should therefore be discussed when obtaining consent for treatment. |
| first_indexed | 2024-03-09T20:23:45Z |
| format | Article |
| id | doaj.art-e332e4c30463432db8962851eacdcde0 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T20:23:45Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-e332e4c30463432db8962851eacdcde02023-11-23T23:41:20ZengMDPI AGCurrent Oncology1198-00521718-77292022-10-0129107953796310.3390/curroncol29100629Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma PatientsJustin Tong0Adi Kartolo1Cynthia Yeung2Wilma Hopman3Tara Baetz4Department of Oncology, Queen’s University, Kingston, ON K7L 5P9, CanadaDepartment of Oncology, McMaster University, Hamilton, ON L8V 5C2, CanadaDepartment of Medicine, Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Public Heath, Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Oncology, Queen’s University, Kingston, ON K7L 5P9, CanadaICI therapy has greatly improved patient outcomes in melanoma, but at the cost of immune-related adverse events (irAEs). Data on the chronicity of irAEs, especially in real-world settings, are currently limited. We performed a retrospective chart review of 161 adult patients with melanoma treated with at least one cycle of ICI regimen in the adjuvant or metastatic setting: 129 patients received PD-1 inhibitor monotherapy and 32 received dual immunotherapy. Patients were grouped by duration of irAE: permanent (no complete resolution), long-term (resolution over a period ≥ 6 months), transient (resolution over a period < 6 months), or no irAEs. A total of 283 irAEs were reported in the whole patient population. Sixty-six (41.0%) patients developed permanent irAEs, fifteen (9.3%) experienced long-term irAEs as their longest-lasting toxicity, thirty-four (21.1%) developed transient irAEs only, and forty-six (28.6%) experienced no irAEs. Permanent irAEs occurred in 21 (65.6%) patients treated with dual immunotherapy and in 45 (34.9%) patients treated with monotherapy. The majority of permanent irAEs were endocrine-related (36.0%) or skin-related (32.4%). Grade 3–4 permanent irAEs occurred in 20 (12.4%) patients and included toxicities such as adrenal insufficiency, myocarditis, and myelitis. Fifty-three (32.9%) patients were still requiring treatment for long-term or permanent irAEs 6 months or more following the completion of ICI therapy, including twenty-four patients on thyroid hormone replacement and twenty-two on oral steroids. ICI treatment was temporarily interrupted for 64 (22.6%) irAEs and permanently discontinued due to irAEs in 38 patients (13.6% of irAEs, 23.6% of patients); additionally, 4 (2.5%) patients died of irAEs. Our findings show that ICI treatment in melanoma is associated with a wide range of toxicities that can be permanent and may have long-lasting impacts on patients, which should therefore be discussed when obtaining consent for treatment.https://www.mdpi.com/1718-7729/29/10/629oncologyimmune checkpoint inhibitorimmunotherapymelanoma |
| spellingShingle | Justin Tong Adi Kartolo Cynthia Yeung Wilma Hopman Tara Baetz Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients Current Oncology oncology immune checkpoint inhibitor immunotherapy melanoma |
| title | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
| title_full | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
| title_fullStr | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
| title_full_unstemmed | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
| title_short | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
| title_sort | long term toxicities of immune checkpoint inhibitor ici in melanoma patients |
| topic | oncology immune checkpoint inhibitor immunotherapy melanoma |
| url | https://www.mdpi.com/1718-7729/29/10/629 |
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