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

Zhang, Shijia; Tang, Kimberly; Wan, Guihong; Nguyen, Nga; Lu, Chenyue; Ugwu‐Dike, Pearl; Raval, Neel S.; Seo, Jayhyun; Alexander, Nora A.; Jairath, Ruple; Phillipps, Jordan; Leung, Bonnie; Roster, Kathleen; Chen, Wenxin; Zubiri, Leyre; Boland, Genevieve M.; Chen, Shuo; Demehri, Shadmehr; LeBoeuf, Nicole R.; Reynolds, Kerry L.; Yu, Kun‐Hsing; Gusev, Alexander; Kwatra, Shawn G.; Semenov, Yevgeniy R.

doi:10.1016/j.jaad.2022.12.048

Cited by 24 publications

(27 citation statements)

References 33 publications

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“…Two additional studies were discovered through a search of the citations of relevant studies. The meta-analysis comprised 23 articles that satisfied the established criteria, involving a total of 22 749 patients …”

Section: Resultsmentioning

confidence: 99%

“…The eTable in Supplement 1 provides an overview of the study characteristics. The majority of studies (n = 21) were retrospective, whereas 2 were prospective and 1 was a randomized clinical trial . All included studies examined the association between cirAE development and cancer prognosis.…”

Section: Resultsmentioning

confidence: 99%

“…In terms of ICI type, most eligible studies focused on PD-1 inhibitors and/or PD-L1 inhibitors; only 2 studies examined CTLA-4 inhibitors . With regard to geographic region, 8 studies were conducted in Asia-Pacific countries, 8 in European countries, and 7 in the US . In terms of cancer type, 9 studies focused on melanoma, 7 on NSCLC, and 1 on metastatic renal cell carcinoma; the remaining 6 included mixed tumor types …”

Section: Resultsmentioning

confidence: 99%

“…With regard to geographic region, 8 studies were conducted in Asia-Pacific countries, 8 in European countries, and 7 in the US . In terms of cancer type, 9 studies focused on melanoma, 7 on NSCLC, and 1 on metastatic renal cell carcinoma; the remaining 6 included mixed tumor types …”

Section: Resultsmentioning

confidence: 99%

“…Nelson et al presented OS and PFS data for the bullous pemphigoid subtype. Tang et al and Zhang et al reported OS data for 17 and 10 cirAE types, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Du,

Wu,

Chen

et al. 2023

JAMA Dermatol

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ImportanceGrowing research suggests that the prevalence of cutaneous immune-related adverse events (cirAEs) is associated with favorable outcomes among individuals with cancer who receive immune checkpoint inhibitor (ICI) treatment.ObjectiveTo identify whether the presence of cirAEs and their subtypes subsequent to ICI administration is associated with enhanced cancer prognosis.Data SourcesThe PubMed, Embase, Cochrane Library, and Web of Science databases were searched for publications examining the association between cirAE development during ICI treatment and subsequent cancer prognosis. The initial search was limited to English-language publications from database inception until December 31, 2022; a subsequent search was performed on May 21, 2023.Study SelectionTwo reviewers independently scrutinized the identical articles and included those that constituted original research evaluating the association between cirAE development and cancer prognosis.Data Extraction and SynthesisThe search terms, study objectives, and methodological protocols were defined before study initiation. The aforementioned 2 reviewers performed data extraction independently and resolved discrepancies through agreement. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis and the Meta-analysis of Observational Studies in Epidemiology reporting guidelines. The protocol was prospectively registered with PROSPERO. Data analyses were conducted between May 21 and June 1, 2023.Main Outcomes and MeasuresThe major outcome end points were overall survival (OS) and progression-free survival (PFS). Subgroup analyses were also conducted according to cirAE type, cancer type, geographic region, study design, and ICI type. Given the heterogeneity inherent in the included studies, a DerSimonian-Laird random-effects model was adopted.ResultsThis systematic review and meta-analysis included 23 studies with a total of 22 749 patients treated with ICIs. The occurrence of cirAEs was associated with improved OS (hazard ratio [HR], 0.61 [95% CI, 0.52-0.72]; P &lt; .001) and PFS (HR, 0.52 [95% CI, 0.41-0.65]; P &lt; .001). Consistent results were observed across all subgroups stratified by study design, geographic region, ICI type, and cancer type, aligning with the overall estimate of OS and PFS improvement. However, no statistically significant differences were identified in terms of PFS within studies conducted in the US.Conclusions and RelevanceIn this systematic review and meta-analysis, the presence of cirAEs and their subtypes was associated with improved prognosis for individuals with cancer undergoing ICI treatment. These findings suggest that cirAEs may have useful prognostic value in ICI treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Nelson et al presented OS and PFS data for the bullous pemphigoid subtype. Tang et al and Zhang et al reported OS data for 17 and 10 cirAE types, respectively.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Du,

Wu,

Chen

et al. 2023

JAMA Dermatol

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Analysis of immune‐related adverse events in gastrointestinal malignancy patients treated with immune checkpoint inhibitors

Niu,

Zhu,

Zhang

et al. 2023

Intl Journal of Cancer

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Immune checkpoint inhibitors are becoming an increasingly common treatment for advanced gastrointestinal cancer, but the possibility of immune‐related adverse events has raised concerns. This study aimed to evaluate the risks of immune‐related adverse events between patients who received immune checkpoint inhibitors and those who received chemotherapy among different types of gastrointestinal cancer. The study utilized data from the multicenter TriNetX database in the United States covering the period between 2015 and 2022. Hazard ratios and 95% confidence intervals were used to describe the relative hazard of immune‐related adverse events based on comparing time‐to‐event rates. Our study revealed that the incidence of immune‐related adverse events was significantly higher in patients who received immune checkpoint inhibitors and chemotherapy compared to those who received chemotherapy only in treating gastrointestinal cancer. CTLA‐4 inhibitors tended to have a higher rate of immune‐related adverse events compared to PD‐1/PD‐L1 inhibitors. Our study found a lower mortality rate among patients who developed immune‐related adverse events compared to those who did not after propensity score matching (HR, 0.661; 95% CI 0.620–0.704; p < .01). We provide important real‐world data on the incidence and impact of immune‐related adverse events in patients with advanced gastrointestinal cancer treated with immune checkpoint inhibitors. Our study's results support clinicians in making informed decisions about the potential benefits and risks of immune checkpoint inhibitor therapy for patients with gastrointestinal cancer.

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Immune checkpoint inhibitor associated epidermal necrosis, beyond SJS and TEN: a review of 98 cases

Bray,

Lin,

et al. 2024

Arch Dermatol Res

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

Cited by 24 publications

References 33 publications

Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Cutaneous Adverse Events and Cancer Survival Prognosis With Immune Checkpoint Inhibitor Treatment

Analysis of immune‐related adverse events in gastrointestinal malignancy patients treated with immune checkpoint inhibitors

Immune checkpoint inhibitor associated epidermal necrosis, beyond SJS and TEN: a review of 98 cases

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