AI Article Synopsis
- Cutaneous immune-related adverse events (cirAEs), affecting up to 40% of patients receiving immune checkpoint inhibitors (ICIs), might play a role in enhancing survival rates for these patients.
- A study reviewed charts of 3,731 ICI recipients, finding that 18.1% developed cirAEs, which were linked to decreased mortality (HR=0.87, p=0.027), particularly among melanoma patients (HR=0.67, p=0.003).
- Various specific skin manifestations, like lichenoid and psoriasiform eruptions, showed significant associations with better survival outcomes in ICI recipients after adjustments for other factors.
Article Abstract
Background: Cutaneous immune-related adverse events (cirAEs) occur in up to 40% of immune checkpoint inhibitor (ICI) recipients. However, the association of cirAEs with survival remains unclear.
Objective: To investigate the association of cirAEs with survival among ICI recipients.
Methods: ICI recipients were identified from the Mass General Brigham healthcare system (MGB) and Dana-Farber Cancer Institute (DFCI). Patient charts were reviewed for cirAE development within 2 years after ICI initiation. Multivariate time-varying Cox proportional hazards models, adjusted for age, sex, race/ethnicity, Charlson Comorbidity Index, ICI type, cancer type, and year of ICI initiation were utilized to investigate the impact of cirAE development on overall survival.
Results: Of the 3,731 ICI recipients, 18.1% developed a cirAE. 6-month landmark analysis and time-varying Cox proportional hazards models demonstrated that patients who developed cirAEs were associated with decreased mortality (HR=0.87,p=0.027), particularly in melanoma patients (HR=0.67,p=0.003). Among individual morphologies, lichenoid eruption (HR=0.51,p<0.001), psoriasiform eruption (HR=0.52,p=0.005), vitiligo (HR=0.29,p=0.007), isolated pruritus without visible manifestation of rash (HR=0.71,p=0.007), acneiform eruption (HR =0.34,p=0.025), and non-specific rash (HR=0.68, p<0.001) were significantly associated with better survival after multiple comparisons adjustment.
Limitations: Retrospective design; single geography.
Conclusion: CirAE development is associated with improved survival among ICI recipients, especially melanoma patients.
Capsule Summary: Patients on immune checkpoint inhibitors (ICIs) who developed cutaneous immune-related adverse events (cirAEs) had favorable outcomes. This was especially notable for melanoma patients who had cirAEs, both those with vitiligo and other morphologies.Development of cirAEs in ICI-treated patients can be used to prognosticate survival and guide treatment decisions.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9882466 | PMC |
| http://dx.doi.org/10.1101/2023.01.16.23284635 | DOI Listing |
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