Delayed immune-related adverse events with anti-PD-1-based immunotherapy in melanoma.

Details

Serval ID
serval:BIB_4024F0C5F587
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Delayed immune-related adverse events with anti-PD-1-based immunotherapy in melanoma.
Journal
Annals of oncology
Author(s)
Owen C.N., Bai X., Quah T., Lo S.N., Allayous C., Callaghan S., Martínez-Vila C., Wallace R., Bhave P., Reijers ILM, 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.
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
07/2021
Peer-reviewed
Oui
Volume
32
Number
7
Pages
917-925
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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 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.
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 and 16 patients (14%) 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 (<12 months) had also occurred in 69 patients (58%), affecting a different organ from the delayed irAE in 59 patients (86%).
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.
Keywords
anti-PD1, delayed, immunotherapy, irAE, melanoma, toxicity, Immunotherapy, anti-PD-1
Pubmed
Web of science
Create date
24/04/2021 15:57
Last modification date
12/10/2021 6:40
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