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. 2021 Feb 27;13(5):989.
doi: 10.3390/cancers13050989.

Immune-Related Adverse Events (irAE) in Cancer Immune Checkpoint Inhibitors (ICI) and Survival Outcomes Correlation: To Rechallenge or Not?

Heidar J Albandar  1 , Jacob Fuqua  2 , Jasim M Albandar  3 , Salahuddin Safi  1 , Samuel A Merrill  1 , Patrick C Ma  4
Affiliations

Immune-Related Adverse Events (irAE) in Cancer Immune Checkpoint Inhibitors (ICI) and Survival Outcomes Correlation: To Rechallenge or Not?

Heidar J Albandar et al. Cancers (Basel). .

Abstract

Introduction: There is growing recognition of immune related adverse events (irAEs) from immune checkpoint therapies being correlated with treatment outcomes in certain malignancies. There are currently limited data or consensus to guide management of irAEs with regards to treatment rechallenge.

Methods: We conducted a retrospective analysis with an IRB-approved protocol of adult patients seen at the WVU Cancer Institute between 2011-2019 with a histopathologic diagnosis of active cancers and were treated with immune checkpoint inhibitors (ICI) therapy.

Results: Demographics were similar between the ICI interrupted irAE groups within cancer types. Overall, out of 548 patients who received ICI reviewed, there were 133 cases of ≥1 irAE found of any grade. Being treated with anti-CTLA-4 inhibitor ICI was associated with lower risk of death compared to anti-PD-1 ICI. The overall survival difference observed for irAE positive patients, between rechallenged (37.8 months, reinitiated with/without interruption; 38.6 months, reinitiated after interruption) and interrupted/non-reinitiated (i.e., discontinued) groups (24.9 months) was not statistically significant, with a numerical trend favoring the former.

Conclusions: Our exploratory study did not identify significantly different survival outcomes among the Appalachian West Virginia adult cancer patients treated with ICI who developed irAE and had treatment reinitiated after interruption, when compared with those not reinitiated.

Keywords: checkpoint inhibitor; immune related adverse event; rechallenge of immunotherapy.

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Conflict of interest statement

Dr. Patrick C. Ma declares the potential conflicts of interest as: speakers’ bureau in Merck, AstraZeneca and Bristol-Myers Squibb; and ad hoc consulting with AstraZeneca. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier Survival Analysis of Study Patients with ICI irAEs Having ICI Interrupted and Not Reinitiated (i.e., Discontinued) (blue) versus Interrupted and Reinitiated (red).
See this image and copyright information in PMC

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