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Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients
ICI therapy has greatly improved patient outcomes in melanoma, but at the cost of immune-related adverse events (irAEs). Data on the chronicity of irAEs, especially in real-world settings, are currently limited. We performed a retrospective chart review of 161 adult patients with melanoma treated wi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600354/ https://www.ncbi.nlm.nih.gov/pubmed/36290906 http://dx.doi.org/10.3390/curroncol29100629 |
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author | Tong, Justin Kartolo, Adi Yeung, Cynthia Hopman, Wilma Baetz, Tara |
author_facet | Tong, Justin Kartolo, Adi Yeung, Cynthia Hopman, Wilma Baetz, Tara |
author_sort | Tong, Justin |
collection | PubMed |
description | ICI therapy has greatly improved patient outcomes in melanoma, but at the cost of immune-related adverse events (irAEs). Data on the chronicity of irAEs, especially in real-world settings, are currently limited. We performed a retrospective chart review of 161 adult patients with melanoma treated with at least one cycle of ICI regimen in the adjuvant or metastatic setting: 129 patients received PD-1 inhibitor monotherapy and 32 received dual immunotherapy. Patients were grouped by duration of irAE: permanent (no complete resolution), long-term (resolution over a period ≥ 6 months), transient (resolution over a period < 6 months), or no irAEs. A total of 283 irAEs were reported in the whole patient population. Sixty-six (41.0%) patients developed permanent irAEs, fifteen (9.3%) experienced long-term irAEs as their longest-lasting toxicity, thirty-four (21.1%) developed transient irAEs only, and forty-six (28.6%) experienced no irAEs. Permanent irAEs occurred in 21 (65.6%) patients treated with dual immunotherapy and in 45 (34.9%) patients treated with monotherapy. The majority of permanent irAEs were endocrine-related (36.0%) or skin-related (32.4%). Grade 3–4 permanent irAEs occurred in 20 (12.4%) patients and included toxicities such as adrenal insufficiency, myocarditis, and myelitis. Fifty-three (32.9%) patients were still requiring treatment for long-term or permanent irAEs 6 months or more following the completion of ICI therapy, including twenty-four patients on thyroid hormone replacement and twenty-two on oral steroids. ICI treatment was temporarily interrupted for 64 (22.6%) irAEs and permanently discontinued due to irAEs in 38 patients (13.6% of irAEs, 23.6% of patients); additionally, 4 (2.5%) patients died of irAEs. Our findings show that ICI treatment in melanoma is associated with a wide range of toxicities that can be permanent and may have long-lasting impacts on patients, which should therefore be discussed when obtaining consent for treatment. |
format | Online Article Text |
id | pubmed-9600354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96003542022-10-27 Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients Tong, Justin Kartolo, Adi Yeung, Cynthia Hopman, Wilma Baetz, Tara Curr Oncol Article ICI therapy has greatly improved patient outcomes in melanoma, but at the cost of immune-related adverse events (irAEs). Data on the chronicity of irAEs, especially in real-world settings, are currently limited. We performed a retrospective chart review of 161 adult patients with melanoma treated with at least one cycle of ICI regimen in the adjuvant or metastatic setting: 129 patients received PD-1 inhibitor monotherapy and 32 received dual immunotherapy. Patients were grouped by duration of irAE: permanent (no complete resolution), long-term (resolution over a period ≥ 6 months), transient (resolution over a period < 6 months), or no irAEs. A total of 283 irAEs were reported in the whole patient population. Sixty-six (41.0%) patients developed permanent irAEs, fifteen (9.3%) experienced long-term irAEs as their longest-lasting toxicity, thirty-four (21.1%) developed transient irAEs only, and forty-six (28.6%) experienced no irAEs. Permanent irAEs occurred in 21 (65.6%) patients treated with dual immunotherapy and in 45 (34.9%) patients treated with monotherapy. The majority of permanent irAEs were endocrine-related (36.0%) or skin-related (32.4%). Grade 3–4 permanent irAEs occurred in 20 (12.4%) patients and included toxicities such as adrenal insufficiency, myocarditis, and myelitis. Fifty-three (32.9%) patients were still requiring treatment for long-term or permanent irAEs 6 months or more following the completion of ICI therapy, including twenty-four patients on thyroid hormone replacement and twenty-two on oral steroids. ICI treatment was temporarily interrupted for 64 (22.6%) irAEs and permanently discontinued due to irAEs in 38 patients (13.6% of irAEs, 23.6% of patients); additionally, 4 (2.5%) patients died of irAEs. Our findings show that ICI treatment in melanoma is associated with a wide range of toxicities that can be permanent and may have long-lasting impacts on patients, which should therefore be discussed when obtaining consent for treatment. MDPI 2022-10-20 /pmc/articles/PMC9600354/ /pubmed/36290906 http://dx.doi.org/10.3390/curroncol29100629 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tong, Justin Kartolo, Adi Yeung, Cynthia Hopman, Wilma Baetz, Tara Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
title | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
title_full | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
title_fullStr | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
title_full_unstemmed | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
title_short | Long-Term Toxicities of Immune Checkpoint Inhibitor (ICI) in Melanoma Patients |
title_sort | long-term toxicities of immune checkpoint inhibitor (ici) in melanoma patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600354/ https://www.ncbi.nlm.nih.gov/pubmed/36290906 http://dx.doi.org/10.3390/curroncol29100629 |
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