Delayed immune-related adverse events with anti-PD1-based immunotherapy in melanoma

Autor: N. Thompson, Christian U. Blank, Adnan Khattak, Alice Labianca, A. Arance, T. Quah, Wen Xu, Clara Allayous, C. Martínez-Vila, Ryan J. Sullivan, Roslyn Wallace, P.A. Ascierto, Sarah J. Welsh, Carina N. Owen, Shahneen Sandhu, Prachi Bhave, V. Vanella, Xue Bai, Jennifer L. McQuade, Céleste Lebbé, Bart Neyns, Matteo S. Carlino, Irene L.M. Reijers, J. Mangana, Serigne Lo, Sophia Callaghan, Mario Mandalà, Sandrine Aspeslagh, Olivier Michielin, Camille L. Gerard, Paul Lorigan, Douglas B. Johnson, Andrew Haydon, Lisa Zimmer, Georgina V. Long, A.M. Menzies
Přispěvatelé: Faculty of Sciences and Bioengineering Sciences, Laboratory for Medical and Molecular Oncology, Clinical sciences, Medical Oncology, Faculty of Psychology and Educational Sciences, Physics
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Owen, C N, Bai, X, Quah, T, Lo, S N, Allayous, C, Callaghan, S, Martínez-Vila, C, Wallace, R, Bhave, P, Reijers, I L M, Thompson, N, Vanella, V, Gerard, C L, Aspeslagh, S, Labianca, A, Khattak, A, Mandala, M, Xu, W, Neyns, B, Michielin, O, Blank, C U, Welsh, S J, Haydon, A, Sandhu, S, Mangana, J, McQuade, J L, Ascierto, P A, Zimmer, L, Johnson, D B, Arance, A, Lorigan, P, Lebbé, C, Carlino, M S, Sullivan, R J, Long, G V & Menzies, A M 2021, ' Delayed immune-related adverse events with anti-PD-1-based immunotherapy in melanoma ', Annals of Oncology, vol. 32, no. 7, pp. 917-925 . https://doi.org/10.1016/j.annonc.2021.03.204
Popis: BACKGROUND: Immune-related adverse events (irAEs) typically occur within 4 months of starting anti-programmed cell death protein 1 (PD-1)-based therapy [anti-PD-1 ± anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4)], but delayed irAEs (onset >12 months after commencement) can also occur. This study describes the incidence, nature and management of delayed irAEs in patients receiving anti-PD-1-based immunotherapy.PATIENTS AND METHODS: Patients with delayed irAEs from 20 centres were studied. The incidence of delayed irAEs was estimated as a proportion of melanoma patients treated with anti-PD-1-based therapy and surviving >1 year. Onset, clinical features, management and outcomes of irAEs were examined.RESULTS: One hundred and eighteen patients developed a total of 140 delayed irAEs (20 after initial combination with anti-CTLA4), with an estimated incidence of 5.3% (95% confidence interval 4.0-6.9, 53/999 patients at sites with available data). The median onset of delayed irAE was 16 months (range 12-53 months). Eighty-seven patients (74%) were on anti-PD-1 at irAE onset, 15 patients (12%) were 3 months from the last dose of anti-PD-1. The most common delayed irAEs were colitis, rash and pneumonitis; 55 of all irAEs (39%) were ≥grade 3. Steroids were required in 80 patients (68%), as well as an additional immunosuppressive agent in 27 patients (23%). There were two irAE-related deaths: encephalitis with onset during anti-PD-1 and a multiple-organ irAE with onset 11 months after ceasing anti-PD-1. Early irAEs (CONCLUSIONS: Delayed irAEs occur in a small but relevant subset of patients. Delayed irAEs are often different from previous irAEs, may be high grade and can lead to death. They mostly occur in patients still receiving anti-PD-1. The risk of delayed irAE should be considered when deciding the duration of treatment in responding patients. However, patients who stop treatment may also rarely develop delayed irAE.
Databáze: OpenAIRE
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