| Autor: |
Teijeira L; Servicio de Oncología Médica, Hospital Universitario de Navarra, 31008 Pamplona, Spain., Martínez M; Servicio de Oncología Médica, Hospital Universitario Araba, Servicio Vasco de Salud Osakidetza, 01009 Vitoria-Gasteiz, Spain.; Grupo de Investigación en Cáncer de Pulmón, Instituto de Investigación Sanitaria Bioaraba, 01009 Vitoria-Gasteiz, Spain., Moreno A; Servicio de Oncología Médica, Hospital Universitario Galdakao, 48960 Galdácano, Spain., de Elejoste I; Servicio de Oncología Médica, Hospital Universitario Donostia, 20014 San Sebastián, Spain., Ibáñez-Beroiz B; Servicio de Metodología, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain., Arrazubi V; Servicio de Oncología Médica, Hospital Universitario de Navarra, 31008 Pamplona, Spain., Díaz de Corcuera I; Servicio de Oncología Médica, Hospital Universitario Galdakao, 48960 Galdácano, Spain., Elejalde I; Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain.; Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain.; Grupo de Enfermedades Inflamatorias e Inmunomediadas, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain., Campillo-Calatayud A; Grupo de Enfermedades Inflamatorias e Inmunomediadas, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain., Les I; Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain.; Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain.; Grupo de Enfermedades Inflamatorias e Inmunomediadas, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain.; Departamento de Ciencias de la Salud, Universidad Pública de Navarra, 31008 Pamplona, Spain. |
| Abstrakt: |
Several factors have been associated with the occurrence of immune-related adverse events (irAEs) induced by immune checkpoint inhibitor (ICI) therapy. Despite their availability, the predictive value of circulating blood cell parameters remains underexplored. Our aim was to investigate whether baseline values of and early changes in absolute neutrophil count (ANC), absolute lymphocyte count (ALC), other blood cell counts, and lymphocyte-related ratios can predict irAEs and whether sex may differentially influence this potential predictive ability. Of the 145 patients included, 52 patients (35.8%) experienced at least one irAE, with a 1-year cumulative incidence of 41.6%. Using Fine and Gray competing risk models, we identified female sex (hazard ratio (HR) = 2.17, 95% confidence interval (CI) = 1.20-3.85), high ALC before ICI initiation (HR = 1.63, 95% CI = 1.09-2.45), and low ANC after ICI initiation (HR = 0.81, 95% CI = 0.69-0.96) as predictors of irAEs. However, ALC and ANC may only have an impact on the risk of irAEs in women (stratified for female sex, ALC-related HR = 2.61, 95% CI = 1.40-4.86 and ANC-related HR = 0.57, 95% CI = 0.41-0.81). Priority should be given to developing models to predict ICI-related toxicity and their validation in various settings, and such models should assess the impact of patient sex on the risk of toxicity. |
