To investigate the characteristics, onset time, and risk factors of immune-related adverse events (irAEs) and endocrine-irAEs (EirAEs) in cancer patients receiving immune checkpoint inhibitor (ICI) combination therapy, highlighting the differences between the two types of events.
Key Findings:
IrAEs occurred in 113 (38.05%) patients, with 4.38% experiencing grade ≥3 irAEs. The majority of patients received chemotherapy (49.18%) and targeted therapy (36.11%).
The most common irAEs were endocrine (12.12%), gastrointestinal (8.75%), and dermatological (6.73%) toxicities.
Corticosteroid use was a protective factor for irAEs (OR = 0.511, P = 0.016).
Age ≥65 years was associated with a lower risk of irAEs (OR = 0.487, P = 0.006).
Combination with targeted therapy was a risk factor for EirAEs (OR = 2.888, P = 0.020).
The average time to onset of irAEs was 2.43 treatment cycles, with 85.25% emerging within 4 cycles.
Interpretation:
The findings indicate a diverse profile of irAEs in patients treated with ICI combination therapy, with most being low-grade and emerging early in treatment, underscoring the need for vigilant monitoring and management.
Limitations:
The study is retrospective and may be subject to biases, such as selection bias and recall bias.
Further multicenter prospective studies are warranted for validation.
Conclusion:
Risk factors for irAEs and EirAEs were identified, supporting the need for risk-stratified monitoring and early intervention in clinical practice.
With recent data that RAS inhibition can improve survival in metastatic pancreatic cancer, the optimization of these agents has become a research priority. Minh Than, MD, PhD, a clinical and research ...
