Albandar Heidar J, Fuqua Jacob, Albandar Jasim M, Safi Salahuddin, Merrill Samuel A, Ma Patrick C
West Virginia University Cancer Institute, Morgantown, WV 26506, USA.
Department of Medicine, West Virginia University, Morgantown, WV 26506, USA.
Cancers (Basel). 2021 Feb 27;13(5):989. doi: 10.3390/cancers13050989.
There is growing recognition of immune related adverse events (irAEs) from immune checkpoint therapies being correlated with treatment outcomes in certain malignancies. There are currently limited data or consensus to guide management of irAEs with regards to treatment rechallenge.
We conducted a retrospective analysis with an IRB-approved protocol of adult patients seen at the WVU Cancer Institute between 2011-2019 with a histopathologic diagnosis of active cancers and were treated with immune checkpoint inhibitors (ICI) therapy.
Demographics were similar between the ICI interrupted irAE groups within cancer types. Overall, out of 548 patients who received ICI reviewed, there were 133 cases of ≥1 irAE found of any grade. Being treated with anti-CTLA-4 inhibitor ICI was associated with lower risk of death compared to anti-PD-1 ICI. The overall survival difference observed for irAE positive patients, between rechallenged (37.8 months, reinitiated with/without interruption; 38.6 months, reinitiated after interruption) and interrupted/non-reinitiated (i.e., discontinued) groups (24.9 months) was not statistically significant, with a numerical trend favoring the former.
Our exploratory study did not identify significantly different survival outcomes among the Appalachian West Virginia adult cancer patients treated with ICI who developed irAE and had treatment reinitiated after interruption, when compared with those not reinitiated.
免疫检查点疗法引发的免疫相关不良事件（irAE）与某些恶性肿瘤的治疗结果之间的关联日益受到关注。目前，关于irAE再治疗管理的数据或共识有限。
我们按照机构审查委员会（IRB）批准的方案，对2011年至2019年间在西弗吉尼亚大学癌症研究所就诊、经组织病理学诊断为活动性癌症并接受免疫检查点抑制剂（ICI）治疗的成年患者进行了回顾性分析。
各癌症类型中，ICI中断组的人口统计学特征相似。总体而言，在接受ICI治疗的548例患者中，发现133例发生了任何级别的≥1次irAE。与抗PD-1 ICI相比，接受抗CTLA-4抑制剂ICI治疗的患者死亡风险较低。irAE阳性患者中，再治疗组（37.8个月，中断后重新开始/未中断重新开始；38.6个月，中断后重新开始）与中断/未重新开始（即停药）组（24.9个月）的总生存差异无统计学意义，数值趋势有利于前者。
我们的探索性研究未发现，与未重新开始治疗的患者相比，在西弗吉尼亚州阿巴拉契亚地区接受ICI治疗且发生irAE并在中断后重新开始治疗的成年癌症患者的生存结果有显著差异。
