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Multicenter Study
. 2023 May;88(5):1024-1032.
doi: 10.1016/j.jaad.2022.12.048. Epub 2023 Feb 2.

Cutaneous immune-related adverse events are associated with longer overall survival in advanced cancer patients on immune checkpoint inhibitors: A multi-institutional cohort study

Shijia Zhang  1 , Kimberly Tang  2 , Guihong Wan  1 , Nga Nguyen  2 , Chenyue Lu  1 , Pearl Ugwu-Dike  2 , Neel Raval  2 , Jayhyun Seo  2 , Nora A Alexander  2 , Ruple Jairath  2 , Jordan Phillipps  2 , Bonnie W Leung  2 , Kathleen Roster  2 , Wenxin Chen  1 , Leyre Zubiri  3 , Genevieve Boland  4 , Steven T Chen  2 , Hensin Tsao  2 , Shadmehr Demehri  5 , Nicole R LeBoeuf  6 , Kerry L Reynolds  3 , Kun-Hsing Yu  7 , Alexander Gusev  8 , Shawn G Kwatra  9 , Yevgeniy R Semenov  10
Affiliations
Multicenter Study

Cutaneous immune-related adverse events are associated with longer overall survival in advanced cancer patients on immune checkpoint inhibitors: A multi-institutional cohort study

Shijia Zhang et al. J Am Acad Dermatol. 2023 May.

Abstract

Background: Cutaneous immune-related adverse events (cirAEs) occur in up to 40% of immune checkpoint inhibitor (ICI) recipients. However, the association of cirAEs with survival remains unclear.

Objective: To investigate the association of cirAEs with survival among ICI recipients.

Methods: ICI recipients were identified from the Mass General Brigham healthcare system and Dana-Farber Cancer Institute. Patient charts were reviewed for cirAE development within 2 years after ICI initiation. Multivariate time-varying Cox proportional hazards models, adjusted for age, sex, race/ethnicity, Charlson Comorbidity Index, ICI type, cancer type, and year of ICI initiation were utilized to investigate the impact of cirAE development on overall survival.

Results: Of the 3731 ICI recipients, 18.1% developed a cirAE. Six-month landmark analysis and time-varying Cox proportional hazards models demonstrated that patients who developed cirAEs were associated with decreased mortality (hazardratio [HR] = 0.87, P = .027), particularly in patients with melanoma (HR = 0.67, P = .003). Among individual morphologies, lichenoid eruption (HR = 0.51, P < .001), psoriasiform eruption (HR = 0.52, P = .005), vitiligo (HR = 0.29, P = .007), isolated pruritus without visible manifestation of rash (HR = 0.71, P = .007), acneiform eruption (HR = 0.34, P = .025), and non-specific rash (HR = 0.68, P < .001) were significantly associated with better survival after multiple comparisons adjustment.

Limitations: Retrospective design; single geography.

Conclusion: CirAE development is associated with improved survival among ICI recipients, especially patients with melanoma.

Keywords: cutaneous adverse reactions; immune checkpoint inhibitor; immune-related adverse events; immunotherapy; melanoma; mortality; oncology; skin toxicity.

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Conflict of interest statement

Conflicts of interest Dr Semenov is an advisory board member/consultant and has received honoraria from Incyte Corporation, Castle Biosciences, Galderma, and Sanofi outside of the submitted work. Dr Kwatra is an advisory board member/consultant for Abbvie, Celldex Therapeutics, Galderma, Incyte Corporation, Johnson & Johnson, Novartis Pharmaceuticals Corporation, Pfizer, Regeneron Pharmaceuticals, Sanofi, and Kiniksa Pharmaceuticals; and has served as an investigator for Galderma, Kiniksa Pharmaceuticals, Pfizer Inc, and Sanofi. Dr LeBoeuf is a consultant and has received honoraria from Bayer, Seattle Genetics, Sanofi, Silverback, and Synox Therapeutics outside the submitted work.

Figures

Fig 1.
Fig 1.
Study design flowchart. Attached as separate jpeg file in accordance with the JAAD submission checklist. CirAE, Cutaneous immune-related adverse event; ICI, immune checkpoint inhibitor.
See this image and copyright information in PMC

Update of

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