Villa-Crespo Lorena, Podlipnik Sebastian, Anglada Natalia, Izquierdo Clara, Giavedoni Priscila, Iglesias Pablo, Dominguez Mireia, Aya Francisco, Arance Ana, Malvehy Josep, Puig Susana, Carrera Cristina
Melanoma Group, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain.
Medicine Department, Medicine Faculty, Campus Clínic, University of Barcelona, 08036 Barcelona, Spain.
Cancers (Basel). 2022 Feb 27;14(5):1237. doi: 10.3390/cancers14051237.
Immune-related adverse events (irAEs) are frequent and could be associated with improved response to immune checkpoint inhibitors (ICIs). A prospective cohort of advanced melanoma patients receiving ICI as first-line therapy was retrospectively reviewed (January 2011−February 2019). A total of 116 of 153 patients presented with at least one irAE (75.8%). The most frequent irAEs were dermatological (derm irAEs, 50%), asthenia (38%), and gastrointestinal (29%). Most irAEs appeared within the first 90 days, while 11.2% appeared after discontinuation of the therapy. Mild grade 1−2 derm irAEs tended to appear within the first 2 months of therapy with a median time of 65.5 days (IQR 26-139.25), while grade 3−4 derm irAEs appeared later (median 114 days; IQR 69-218) and could be detected at any time during therapy. Only derm irAE occurrence was related to improved survival (HR 6.46). Patients presenting derm irAEs showed better 5-year overall survival compared to those with no derm irAEs (53.1% versus 24.9%; p < 0.001). However, the difference was not significant when adjusting for the duration of therapy. In conclusion: the timeline of immune-related-AEs differs according to the organ involved. The (apparent) improved survival of patients who present derm AEs during immunotherapy could be partially explained by longer times under treatment.
免疫相关不良事件（irAE）很常见，并且可能与免疫检查点抑制剂（ICI）治疗反应的改善有关。对一组接受ICI作为一线治疗的晚期黑色素瘤患者进行了回顾性研究（2011年1月至2019年2月）。153例患者中有116例（75.8%）出现至少一种irAE。最常见的irAE是皮肤相关的（皮肤irAE，50%）、乏力（38%）和胃肠道相关的（29%）。大多数irAE在治疗的前90天内出现，而11.2%在治疗中断后出现。轻度1-2级皮肤irAE倾向于在治疗的前2个月内出现，中位时间为65.5天（四分位间距26-139.25），而3-4级皮肤irAE出现较晚（中位114天；四分位间距69-218），并且在治疗期间的任何时间都可检测到。只有皮肤irAE的发生与生存改善相关（风险比6.46）。出现皮肤irAE的患者与未出现皮肤irAE的患者相比，5年总生存率更高（53.1%对24.9%；p<0.001）。然而，在调整治疗持续时间后，差异不显著。总之：免疫相关不良事件的时间线因受累器官而异。免疫治疗期间出现皮肤不良事件的患者（明显）生存改善可能部分归因于治疗时间更长。
