The determinants of very severe immune-related adverse events associated with immune checkpoint inhibitors: A prospective study of the French REISAMIC registry

Ruste, Valentine; Goldschmidt, Vincent; Laparra, Ariane; Messayke, Sabine; Danlos, François‐Xavier; Romano-Martin, Patricia; Champiat, Stéphane; Voisin, Anne-Laure; Baldini, Capucine; Massard, Christophe; Laghouati, Salim; Marabelle, Aurélien; Lambotte, Olivier; Michot, Jean‐Marie

doi:10.1016/j.ejca.2021.08.048

Cited by 44 publications

(29 citation statements)

References 18 publications

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“…During the treatment, the patient experienced some immune-related adverse events (irAEs) and vascular endothelial growth factor receptor-tyrosine kinase inhibitor toxicity, mainly gastrointestinal toxicity and pneumonia, manifested as abdominal pain, diarrhea, cough and dyspnea, However, the patient developed arteriovenous thrombotic events, which were considered to be caused by cabozantinib, so the drug was discontinued. But the patient insisted on anti-programmed death-1 (PD-1) therapy for two years, during which time, after symptomatic treatment with glucocorticoids, the grade of irAEs could be controlled below grade 1[ 8 ]. After re-follow-up, the dose of nivolumab was changed to 200 mg once every three weeks.The whole treatment process of patients is shown in Table 1 .…”

Section: Treatmentmentioning

confidence: 99%

Combined targeted therapy and immunotherapy in anaplastic thyroid carcinoma with distant metastasis: A case report

Ma¹,

Ding²,

Zhang³

et al. 2022

WJCC

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BACKGROUND Anaplastic thyroid carcinoma (ATC), also called undifferentiated thyroid cancer, is the least common but most aggressive and deadly thyroid gland malignancy of all thyroid cancers[ 1 ]. It has poor prognosis, and is the leading cause of death from malignant thyroid tumors. The one-year survival rate is 20%, with a median overall survival (OS) of only 5 mo[ 2 ]. The aim of this report is to provide our experience in the diagnosis and treatment of ATC. CASE SUMMARY A patient with a thyroid mass underwent surgical treatment after developing symptoms of hoarseness. The resected tumor was pathologically diagnosed as ATC. Imaging examination revealed organ and lymph node metastasis. After multiple cycles of chemotherapy and local radiotherapy, the metastases were not relieved and gradually increased in size and new metastases appeared. The patient immediately received immunotherapy combined with targeted therapy. During treatment, immune-related adverse reactions occurred, which were improved after symptomatic treatment, and tolerated by the patient. The OS of the patient was more than 30 mo after immunotherapy combined with targeted therapy. CONCLUSION For metastatic ATC, surgical treatment, radiotherapy and chemotherapy have no significant effect on remission of the disease. However, immunotherapy has made a breakthrough in the treatment of ATC.

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Section: Treatmentmentioning

confidence: 99%

Combined targeted therapy and immunotherapy in anaplastic thyroid carcinoma with distant metastasis: A case report

Ma¹,

Ding²,

Zhang³

et al. 2022

WJCC

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“…Since September 2014, the prospective REISAMIC registry (Registre des Effets Indésirables Sévères des Anticorps Monoclonaux Immunomodulateurs en Cancérologie, registry of severe adverse events related to immunomodulating monoclonal antibodies used to treat cancer) has been collecting all serious irAEs in adults (≥ 18 years) 12 treated with ICIs under real-life conditions at the Gustave Roussy university cancer centre in Villejuif, France. Additional patients were identi ed via the Gustave Roussy multidisciplinary immunotoxicity assessment panel, to which patients are referred nation-wide by managing physicians seeking assistance in managing irAES.…”

Section: Study Populationmentioning

confidence: 99%

“…However, few data are available about the management of CS-R/R ICI-induced pneumonitis. 11 The primary objective of this study was to describe the response to second-line immunosuppressive therapy in adults with ICI-induced CS-R/R pneumonitis included in the prospective REISAMIC cohort 12 and/or referred to the multidisciplinary immunotoxicity assessment board 13 at the Gustave Roussy university cancer centre in France.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Outcome of Steroid-Resistant/Refractory Pneumonitis Induced by Immune Checkpoint Inhibitors: An Observational Study of the Prospective REISAMIC Registry

Camard

Besse

Cariou

et al. 2022

Preprint

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Background. Anticancer immune-checkpoint inhibitors (ICI) can cause immune-related adverse events (irAEs), including interstitial pneumonitis, which is managed chiefly with systemic corticosteroids. When corticosteroids fail, second-line immunosuppressive therapy is indicated. Our objective was to evaluate the prevalence and outcomes of ICI-induced pneumonitis requiring second-line immunosuppressive therapy (IS).Methods. We collected data form the REISAMIC pharmacovigilance registry and the multidisciplinary immunological toxicity board at Gustave Roussy (France). No response to steroids was called steroid-refractory pneumonitis and relapse after an initial response was defined as steroid-resistant pneumonitis. Results. Of the 1187 patients screened from the REISAMIC register, 48 (4%) patients had pneumonitis treated with corticosteroids. Five of them (10%) had corticosteroid refractory/resistant disease but only 2 were treated with immunosuppressive therapy. Four additional patients requiring immunosuppressive therapy identified via the immunological toxicity board were included. Immunosuppressive therapy were cyclophosphamide (n=4 pts), infliximab (n=1 pt), intravenous immunoglobulins (n=1 pt). Five of these six patients had corticosteroid-refractory disease and one had corticosteroid-resistant pneumonitis. Five patients had severe pneumonitis (Common Terminology Criteria for Adverse Events grade ≥3) at initial pneumonitis diagnosis. Two months mortality rate in patients treated with IS was 67% (4/6). Among the patients treated with IS, the two patients alive at 5 months were treated with cyclophosphamide. Conclusion. Patients with ICI-pneumonitis treated by steroids needed IS in 10% of cases. High mortality at 67% of patients was observed in ICI-pneumonitis after steroid failure. Cyclophosphamide could be a treatment option for pneumonitis after corticosteroid failure.

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“…Targeted therapies (small molecules and monoclonal antibodies) have also been developed; these treatment approaches are based on drugs that target specific signaling pathways involved in cancer development and progression [ 4 , 5 , 6 ]. More recently, the field of cancer treatment has been revolutionized by the development of immunotherapy (i.e., immune checkpoint inhibitors) based on the aim to boost patients’ own immune systems to fight cancer, although several immune-related side effects were reported to be associated with this therapeutic approach [ 7 , 8 ].…”

mentioning

confidence: 99%

Molecular Mechanisms of Cancer Drug Resistance: Emerging Biomarkers and Promising Targets to Overcome Tumor Progression

Fontana

Anselmi

Limonta

2022

Cancers

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The determinants of very severe immune-related adverse events associated with immune checkpoint inhibitors: A prospective study of the French REISAMIC registry

Cited by 44 publications

References 18 publications

Combined targeted therapy and immunotherapy in anaplastic thyroid carcinoma with distant metastasis: A case report

Combined targeted therapy and immunotherapy in anaplastic thyroid carcinoma with distant metastasis: A case report

Prevalence and Outcome of Steroid-Resistant/Refractory Pneumonitis Induced by Immune Checkpoint Inhibitors: An Observational Study of the Prospective REISAMIC Registry

Molecular Mechanisms of Cancer Drug Resistance: Emerging Biomarkers and Promising Targets to Overcome Tumor Progression

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