Endocrine Toxicity and Outcomes in Patients With Metastatic Malignancies Treated With Immune Checkpoint Inhibitors.
J Endocr Soc
; 5(8): bvab100, 2021 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-34195529
ABSTRACT
CONTEXT Immune checkpoint inhibitors (ICIs) have gained a revolutionary role in management of many advanced malignancies. However, immune-related endocrine events (irEEs), have been associated with their use. irEEs have nonspecific clinical presentations and variable timelines, making their early diagnosis challenging. OBJECTIVE:
To identify risk factors, timelines, and prognosis associated with irEEs development. DESIGN ANDSETTING:
Retrospective observational study within the Cleveland Clinic center. PATIENTS Metastatic cancer adult patients who received ICIs were included.METHODS:
570 charts were reviewed to obtain information on demographics, ICIs used, endocrine toxicities, cancer response to treatment with ICI, and overall survival. MAIN OUTCOMEMEASURES:
Incidence of irEEs, time to irEEs development and overall survival of patients who develop irEEs.RESULTS:
The final cohort included 551 patients. The median time for the diagnosis of irEEs was 9 weeks. Melanoma was associated with the highest risk for irEEs (31.3%). Ipilimumab appeared to have the highest percentage of irEEs (29.4%), including the highest risk of pituitary insufficiency (11.7%), the most severe (Grade 4 in 60%) and irreversible (100%) forms of irEEs. Forty-five percent of patients with irEEs had adequate cancer response to ICI compared to 28.3% of patients without irEEs (Pâ =â 0.002). Patients with irEEs had significantly better survival compared to patients without irEEs (Pâ <â 0.001).CONCLUSIONS:
In the adult population with metastatic cancer receiving treatment with ICI, irEEs development may predict tumor response to immunotherapy and a favorable prognosis. Ipilimumab use, combination ICI therapy, and melanoma are associated with a higher incidence of irEEs.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
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Screening_studies
Idioma:
En
Revista:
J Endocr Soc
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos