Juan-Carpena Gloria, Martínez Banaclocha Natividad, Palazón Cabanes Juan Carlos, Niveiro-de Jaime Maria, Betlloch Mas Isabel, Blanes-Martínez Mar
Department of Dermatology, Morales Meseguer University Hospital, Murcia, Spain; Toxirel Investigation Group.
Toxirel Investigation Group, Alicante Spain; Department of Oncology, Dr. Balmis University General Hospital, Alicante, Spain; Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.
Acta Derm Venereol. 2025 Jan 3;105:adv42023. doi: 10.2340/actadv.v105.42023.
Cutaneous immune-related adverse events (cirAEs) may be associated with tumoral response and survival in patients using immune checkpoint inhibitors, but this relationship remains unclear because previous reports on the topic have various limitations. The purpose of this study was to examine the association of cirAEs with overall survival and progression-free survival in patients starting immune checkpoint inhibitors. A prospective observational study was conducted in a Spanish tertiary care hospital, including participants between March 2020 and May 2022. The statistical analysis involved the Kaplan-Meier method, log-rank test, and multivariable Cox proportional hazards regression models. At total of 189 patients were included, of whom 82 (43.4%) presented cirAEs. Most participants (56.6%) were diagnosed with non-small cell lung cancer (NSCLC). Mortality and progression rates were lower in patients with vs without cirAEs (p < 0.0001). Cox models showed that cirAEs were a protective factor for overall survival (adjusted HR 0.50; p < 0.0001) and progression-free survival (adjusted HR 0.54; p = 0.001) independently of cancer type, tumour stage or immune checkpoint inhibitor category. There were similar results for extracutaneous irAEs. A limitation was the single-centre design. CirAE occurrence is positively associated with longer survival and less cancer progression among immune checkpoint inhibitor recipients independently of other factors.
皮肤免疫相关不良事件（cirAEs）可能与使用免疫检查点抑制剂的患者的肿瘤反应和生存相关，但这种关系仍不清楚，因为此前关于该主题的报告存在各种局限性。本研究的目的是探讨在开始使用免疫检查点抑制剂的患者中，cirAEs与总生存期和无进展生存期的关联。在一家西班牙三级护理医院进行了一项前瞻性观察性研究，纳入了2020年3月至2022年5月期间的参与者。统计分析采用Kaplan-Meier法、对数秩检验和多变量Cox比例风险回归模型。总共纳入了189例患者，其中82例（43.4%）出现了cirAEs。大多数参与者（56.6%）被诊断为非小细胞肺癌（NSCLC）。有cirAEs的患者的死亡率和进展率低于无cirAEs的患者（p<0.0001）。Cox模型显示，无论癌症类型、肿瘤分期或免疫检查点抑制剂类别如何，cirAEs都是总生存期（调整后HR 0.50；p<0.0001）和无进展生存期（调整后HR 0.54；p=0.001）的保护因素。皮肤外免疫相关不良事件（irAEs）也有类似结果。一个局限性是单中心设计。在免疫检查点抑制剂接受者中，cirAE的发生与更长的生存期和更少的癌症进展呈正相关，且不受其他因素影响。
