Journal: NPJ precision oncology
This retrospective cohort study analyzed 6,526 adult cancer patients treated with immune checkpoint inhibitors (ICIs) between 2018 and 2022. It examined risk factors, incidence, severity, and clinical outcomes of immune-related adverse events (irAEs).
Key findings include:
- Incidence: Over half (56.2%) developed irAEs within one year, with some cases requiring hospitalization.
- Risk factors: Younger patients (18-29), females, and those with comorbidities such as myocardial infarction, heart failure, and renal disease had higher irAE risk.
- Lower risk associations: Dementia and recent chemotherapy were linked to a reduced irAE risk.
- Treatment impact: Combination CTLA-4 plus PD(L)1 therapy increased irAE risk by 35% compared to PD-1 inhibitors alone.
- Cancer types: Breast and hematologic cancers showed elevated irAE risk, while brain cancer was associated with reduced risk.
- Severity and outcomes: IrAE severity correlated with earlier onset and poorer overall survival.
- Survival analysis: Treatment regimens influenced irAE-free survival in multi-site cancers and overall survival in kidney cancer.
These findings emphasize the importance of individualized irAE risk assessment in cancer patients receiving ICIs.