Immune checkpoint inhibitor-induced hepatitis injury: risk factors, outcomes, and impact on survival.

Autor: Miah A; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Tinoco G; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA. Gabriel.Tinoco@osumc.edu., Zhao S; Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA., Wei L; Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA., Johns A; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Patel S; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Li M; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Grogan M; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Lopez G; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Husain M; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Hoyd R; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Mumtaz K; Division of Gastroenterology Hepatology and Nutrition, The Ohio State University, Columbus, OH, USA., Meara A; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA.; Division of Rheumatology and Immunology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA., Bertino EM; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Kendra K; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Spakowicz D; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Otterson GA; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Presley CJ; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA., Owen DH; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 1810 Cannon Drive, Suite 1240C, Columbus, OH, 43210, USA.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2023 May; Vol. 149 (5), pp. 2235-2242. Date of Electronic Publication: 2022 Sep 07.
DOI: 10.1007/s00432-022-04340-3
Abstrakt: Purpose: Immune checkpoint inhibitors (ICIs) are associated with a unique set of immune-related adverse events (irAEs). Few studies have evaluated the risk factors and outcomes of patients who develop ICI-induced hepatitis (ICIH).
Methods: We utilized an institutional database of patients with advanced cancers treated with ICI to identify patients with ICIH. irAEs were graded using the Common Terminology Criteria for Adverse Events v4. Overall survival (OS) was calculated from the date of ICI to death from any cause or the date of the last follow-up. OS with 95% confidence intervals were estimated using the Kaplan-Meier method and stratified by the occurrence of ICIH.
Results: We identified 1096 patients treated with ICI. The most common ICIs were PD1/L1 (n = 774) and CTLA-4 inhibitors (n = 195). ICIH occurred among 64 (6%) patients: severity was < grade 3 in 30 and ≥ grade 3 in 24 patients (3.1% overall). Median time to ICIH was 63 days. ICIH was more frequent in women (p = 0.038), in patients treated with combination ICIs (p < 0.001), and when given as first-line therapy (p = 0.018). Occurrence of ICIH was associated with significantly longer OS, median 37.0 months (95% CI 21.4, NR) compared to 11.3 months (95% CI 10, 13, p < 0.001); there was no difference in OS between patients with ≥ grade 3 ICIH vs grade 1-2.
Conclusions: Female sex, combination immunotherapy, and the first line of immunotherapy were associated with ICIH. Patients with ICIH had improved clinical survival compared to those that did not develop ICIH. There is a need for prospective further studies to confirm our findings.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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