Hypothesis for the development of immune-related adverse events in immune checkpoint inhibitors therapy

Орлова, Р. В.; Zhukova, Natalia V.; Малкова, Анна; Shoenfeld, Yehuda

doi:10.1016/j.ctarc.2022.100529

Cited by 1 publication

(2 citation statements)

References 43 publications

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“…There were no significant differences in fatigue and physical function among age groups. Researchers have theorized that the mechanism by which ICIs work, immune system activation, may cause increased immune related adverse events (irAEs) and subsequently poorer PROs in younger adults 25,26 . However, immune activation may be muted in older adults potentially leading to less irAEs and more favorable PROs 27 .…”

Section: Discussionmentioning

confidence: 99%

“…Researchers have theorized that the mechanism by which ICIs work, immune system activation, may cause increased immune related adverse events (irAEs) and subsequently poorer PROs in younger adults. 25,26 However, immune activation may be muted in older adults potentially leading to less irAEs and more favorable PROs. 27 Although there is no definitive research supporting this theory, previous studies demonstrate that the human immune system begins to downregulate with age.…”

Section: Clinical Outcomes By Age Groupsmentioning

confidence: 99%

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Associations between age and patient‐reported outcomes, emergency department visits, and hospitalizations among lung cancer patients receiving immune checkpoint inhibitors

Fleszar‐Pavlovic,

Natori,

Moreno

et al. 2024

Psycho-Oncology

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ObjectiveImmune checkpoint inhibitors (ICIs) for lung cancer (LC) treatment have a more favorable safety profile and improved patient reported outcomes (PROs) compared to chemotherapy, suggesting that ICIs are advantageous for older populations. The impact of ICIs on PROs, clinical outcomes, and age in LC patients remains to be established. We examined associations between age and PROs, emergency department (ED) visits, and hospitalizations in LC patients receiving ICIs.MethodsWe performed retrospective analyses via My Wellness Check (MWC), an assessment and triage electronic medical record (EMR) integrated platform in LC patients receiving ICIs. Demographics, clinical characteristics, ED visits, and hospitalizations were extracted via EMR. Patient reported outcomes (PROMIS® anxiety, depression, fatigue, pain, physical function), and health‐related quality of life (HRQOL; FACT‐G7), were collected via MWC. We classified age into three categories (<65, 65–74, ≥75). Multiple regressions examined associations between PROs and age. Cox proportional hazards regressions assessed cumulative ED visits and hospitalizations.ResultsAmong LC patients (N = 190) receiving ICIs, patients ≥75 had lower depression (β = −5.80, p = 0.01) and higher HRQOL (β = 2.47, p = 0.05) compared with patients <65. Relative to patients <65, patients 65–74 had lower anxiety (β = −3.31, p = 0.05) and pain (β = −4.18, p = 0.03). Patients 65–74 and ≥ 75 had lower risk of an ED visit (adjusted hazards ratio [aHR] = 0.45, p = 0.05 and aHR = 0.21, p = 0.05, respectively) and patients 65–74 had lower risk of hospitalization (aHR = 0.36, p = 0.02) relative to patients <65.ConclusionsOlder LC patients (65–74; ≥75) have more favorable PROs and lower risk for negative clinical outcomes than younger (<65) patients.

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Section: Discussionmentioning

confidence: 99%