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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...

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Autores principales: Tong, Justin, Kartolo, Adi, Yeung, Cynthia, Hopman, Wilma, Baetz, Tara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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