Immune checkpoint inhibitors (ICIs) have radically changed the clinical outcome of several cancers with durable responses. CTLA-4 (cytotoxic T lymphocyte antigen-4), PD-1 (programmed cell death protein 1) or PDL-1 (programmed cell death ligand protein 1) represent ICIs that can be used as monotherapy or in combination with other agents. The toxicity p\rofiles of ICIs differ from the side effects of cytotoxic agents and come with new toxicities like immune-related adverse events. Typically, these toxicities occur in all organs. However, the main organs affected are the skin, digestive, hepatic, lungs, rheumatologic, and endocrine. Most of the immune toxicity that occurs is low grade but some more severe toxicities can occur that require a rapid diagnosis and appropriate treatment. The recognition of symptoms by physicians and patient is necessary to resolve them rapidly and adapt treatment to allow the toxicity to resolve.

No impact of psychosocial stress on development of glioblastomaPurpose: Psychosocial stress represents an important source of questions in the potential implication of origin of cancer. The aim of the study was to assess stress prevalence prior to diagnosis of wild-type IDH glioblastoma.Methods: This prospective single-center study enrolled consecutive new cases of wild-type IDH glioblastoma diagnosed between December 2019 and March 2021 at the University Hospital of Bordeaux. A standardized patient self-assessment stress questionnaire explored both the presence of stressor exposure and the intensity of patient stress level prior to the diagnosis. Four groups were included: high stressors/high stress, high stressors/low stress, low stressors/low stress, and low stressors/high stress. Patient characteristics were collected. Statistical analysis was based on the Chi-square test and the Kaplan-Meier survival estimator.Results: Sixty-four patients with a median age of 66 years were included. Glioblastoma involved predominantly the frontal lobe (39%). Thirty-six patients (56.3%) presented a low stressor/low stress profile. Stress corresponded mainly to the death of a loved one or to family health problems. Among working professionals, 20 patients (67.5%) reported low-intensity work stress. A history of depression was found in 30%. Progression-free survival at 6 months was 45.3% and median overall survival was estimated to be 16.5 months. Level and presence of stress did not differ based on location of tumour. No association was found between stress and tumour progression or overall survival.Conclusion: A majority of patients in this study had low exposure to stressors as well as low stress level. Psychological stress did not seem to favour the emergence of glioblastoma or survival.

Purpose: Psychosocial stress represents an important source of questions in the potential implication of origin of cancer. The aim of the study was to assess stress prevalence prior to diagnosis of wild-type IDH glioblastoma.Methods: This prospective single-center study enrolled consecutive new cases of wild-type IDH glioblastoma diagnosed between December 2019 and March 2021 at the University Hospital of Bordeaux. A standardized patient self-assessment stress questionnaire explored both the presence of stressor exposure and the intensity of patient stress level prior to the diagnosis. Four groups were included: high stressors/high stress, high stressors/low stress, low stressors/low stress, and low stressors/high stress. Patient characteristics were collected. Statistical analysis was based on the Chi-square test and the Kaplan-Meier survival estimator.Results: Sixty-four patients with a median age of 66 years were included. Glioblastoma involved predominantly the frontal lobe (39%). Thirty-six patients (56.3%) presented a low stressor/low stress profile. Stress corresponded mainly to the death of a loved one or to family health problems. Among working professionals, 20 patients (67.5%) reported low-intensity work stress. A history of depression was found in 30%. Progression-free survival at 6 months was 45.3% and median overall survival was estimated to be 16.5 months. Level and presence of stress did not differ based on location of tumour. No association was found between stress and tumour progression or overall survival.Conclusion: A majority of patients in this study had low exposure to stressors as well as low stress level. Psychological stress did not seem to favour the emergence of glioblastoma or survival.