The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes
Background: Immune checkpoint inhibitors (ICPIs) are gaining more popularity as a treatment for advanced cancers. However, immune-related adverse events (irAEs) limit their use. We aimed to assess the impact of irAEs and their treatment on clinical and survival outcomes. Materials and Methods: We re...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Innovative Healthcare Institute
2018-07-01
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| Series: | Journal of Immunotherapy and Precision Oncology |
| Subjects: | |
| Online Access: | https://jipo.org/doi/pdf/10.4103/JIPO.JIPO_12_18 |
| _version_ | 1797962755837263872 |
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| author | Hamzah Abu-Sbeih Tenglong Tang Faisal Shaukat Ali Daniel Hartman Johnson Wei Qiao Adi Diab Yinghong Wang |
| author_facet | Hamzah Abu-Sbeih Tenglong Tang Faisal Shaukat Ali Daniel Hartman Johnson Wei Qiao Adi Diab Yinghong Wang |
| author_sort | Hamzah Abu-Sbeih |
| collection | DOAJ |
| description | Background: Immune checkpoint inhibitors (ICPIs) are gaining more popularity as a treatment for advanced cancers. However, immune-related adverse events (irAEs) limit their use. We aimed to assess the impact of irAEs and their treatment on clinical and survival outcomes. Materials and Methods: We retrospectively reviewed records of the patients who received ICPIs between 2011 and 2017. Descriptive analyses were employed to compare different groups. Kaplan–Meier curves and log-rank tests were used to estimate and compare overall survival durations. Results: Of 427 identified patients, 202 (47.3%) had one or more irAEs. Overall, the patients who developed irAEs had better overall survival than did patients with no-irAEs, regardless of immunosuppressant treatment (P < 0.01). Patients with mild irAEs who did not require immunosuppressive treatment had longer overall survival duration than did patients without irAEs (P < 0.01). Patients with three or more irAEs had longer median overall survival compared to patients with two or less irAEs (P = 0.01). Infliximab was associated with shorter duration of steroid use as compared to steroid treatment only (2 months [standard deviation (SD), 8] vs. 4 months [SD, 4]). Steroid treatment for >30 days was associated with higher rate of infections compared to shorter duration (P = 0.03). Conclusion: IrAEs are associated with favorable overall survival, regardless of immunosuppression treatment requirement. IrAEs involving multiple organs appeared to be beneficial for overall survival. Early infliximab use shortens the duration of steroid treatment and therefore balances better cancer outcomes with decreased risk of infection. |
| first_indexed | 2024-04-11T01:17:56Z |
| format | Article |
| id | doaj.art-f7d076deb26e4f7685b1a62e5109d7cc |
| institution | Directory Open Access Journal |
| issn | 2666-2345 2590-017X |
| language | English |
| last_indexed | 2024-04-11T01:17:56Z |
| publishDate | 2018-07-01 |
| publisher | Innovative Healthcare Institute |
| record_format | Article |
| series | Journal of Immunotherapy and Precision Oncology |
| spelling | doaj.art-f7d076deb26e4f7685b1a62e5109d7cc2023-01-03T19:50:29ZengInnovative Healthcare InstituteJournal of Immunotherapy and Precision Oncology2666-23452590-017X2018-07-0171810.4103/JIPO.JIPO_12_18i2590-017X-1-1-7The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ OutcomesHamzah Abu-Sbeih0Tenglong Tang1Faisal Shaukat Ali2Daniel Hartman Johnson3Wei Qiao4Adi Diab5Yinghong Wang6Departments of Gastroenterology, Hepatology and NutritionDepartments of Gastroenterology, Hepatology and NutritionDepartments of Gastroenterology, Hepatology and Nutrition1 Melanoma Medical Oncology and2 Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA1 Melanoma Medical Oncology andDepartments of Gastroenterology, Hepatology and NutritionBackground: Immune checkpoint inhibitors (ICPIs) are gaining more popularity as a treatment for advanced cancers. However, immune-related adverse events (irAEs) limit their use. We aimed to assess the impact of irAEs and their treatment on clinical and survival outcomes. Materials and Methods: We retrospectively reviewed records of the patients who received ICPIs between 2011 and 2017. Descriptive analyses were employed to compare different groups. Kaplan–Meier curves and log-rank tests were used to estimate and compare overall survival durations. Results: Of 427 identified patients, 202 (47.3%) had one or more irAEs. Overall, the patients who developed irAEs had better overall survival than did patients with no-irAEs, regardless of immunosuppressant treatment (P < 0.01). Patients with mild irAEs who did not require immunosuppressive treatment had longer overall survival duration than did patients without irAEs (P < 0.01). Patients with three or more irAEs had longer median overall survival compared to patients with two or less irAEs (P = 0.01). Infliximab was associated with shorter duration of steroid use as compared to steroid treatment only (2 months [standard deviation (SD), 8] vs. 4 months [SD, 4]). Steroid treatment for >30 days was associated with higher rate of infections compared to shorter duration (P = 0.03). Conclusion: IrAEs are associated with favorable overall survival, regardless of immunosuppression treatment requirement. IrAEs involving multiple organs appeared to be beneficial for overall survival. Early infliximab use shortens the duration of steroid treatment and therefore balances better cancer outcomes with decreased risk of infection.https://jipo.org/doi/pdf/10.4103/JIPO.JIPO_12_18adverse eventsimmune checkpoint inhibitorimmunosuppressive treatmentimmunotherapyimpactsurvivaltoxicities |
| spellingShingle | Hamzah Abu-Sbeih Tenglong Tang Faisal Shaukat Ali Daniel Hartman Johnson Wei Qiao Adi Diab Yinghong Wang The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes Journal of Immunotherapy and Precision Oncology adverse events immune checkpoint inhibitor immunosuppressive treatment immunotherapy impact survival toxicities |
| title | The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes |
| title_full | The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes |
| title_fullStr | The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes |
| title_full_unstemmed | The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes |
| title_short | The Impact of Immune Checkpoint Inhibitor-Related Adverse Events and Their Immunosuppressive Treatment on Patients’ Outcomes |
| title_sort | impact of immune checkpoint inhibitor related adverse events and their immunosuppressive treatment on patients outcomes |
| topic | adverse events immune checkpoint inhibitor immunosuppressive treatment immunotherapy impact survival toxicities |
| url | https://jipo.org/doi/pdf/10.4103/JIPO.JIPO_12_18 |
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