Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations

ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities ha...
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Autor*in:	Benjamin C. Park [verfasserIn] Sathya Narayanan [verfasserIn] Alexander Gavralidis [verfasserIn] Fei Ye [verfasserIn] Run Fan [verfasserIn] Ryan J. Sullivan [verfasserIn] Genevieve Boland [verfasserIn] Kerry L Reynolds [verfasserIn] Justin M. Balko [verfasserIn] Matteo S. Carlino [verfasserIn] Georgina V. Long [verfasserIn] Leyre Zubiri [verfasserIn] Alexander M. Menzies [verfasserIn] Douglas B. Johnson [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events

Übergeordnetes Werk:	In: OncoImmunology - Taylor & Francis Group, 2020, 12(2023), 1
Übergeordnetes Werk:	volume:12 ; year:2023 ; number:1

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1080/2162402X.2023.2188719

Katalog-ID:	DOAJ087944367

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520			\|a ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon.
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allfields	10.1080/2162402X.2023.2188719 doi (DE-627)DOAJ087944367 (DE-599)DOAJ5fea4b8fffe544958754d98c4b9d90c4 DE-627 ger DE-627 rakwb eng RC581-607 RC254-282 Benjamin C. Park verfasserin aut Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon. Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events Immunologic diseases. Allergy Neoplasms. Tumors. Oncology. Including cancer and carcinogens Sathya Narayanan verfasserin aut Alexander Gavralidis verfasserin aut Fei Ye verfasserin aut Run Fan verfasserin aut Ryan J. Sullivan verfasserin aut Genevieve Boland verfasserin aut Kerry L Reynolds verfasserin aut Justin M. Balko verfasserin aut Matteo S. Carlino verfasserin aut Georgina V. Long verfasserin aut Leyre Zubiri verfasserin aut Alexander M. Menzies verfasserin aut Douglas B. Johnson verfasserin aut In OncoImmunology Taylor & Francis Group, 2020 12(2023), 1 (DE-627)683365428 (DE-600)2645309-5 2162402X nnns volume:12 year:2023 number:1 https://doi.org/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/article/5fea4b8fffe544958754d98c4b9d90c4 kostenfrei https://www.tandfonline.com/doi/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/toc/2162-402X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 1
spelling	10.1080/2162402X.2023.2188719 doi (DE-627)DOAJ087944367 (DE-599)DOAJ5fea4b8fffe544958754d98c4b9d90c4 DE-627 ger DE-627 rakwb eng RC581-607 RC254-282 Benjamin C. Park verfasserin aut Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon. Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events Immunologic diseases. Allergy Neoplasms. Tumors. Oncology. Including cancer and carcinogens Sathya Narayanan verfasserin aut Alexander Gavralidis verfasserin aut Fei Ye verfasserin aut Run Fan verfasserin aut Ryan J. Sullivan verfasserin aut Genevieve Boland verfasserin aut Kerry L Reynolds verfasserin aut Justin M. Balko verfasserin aut Matteo S. Carlino verfasserin aut Georgina V. Long verfasserin aut Leyre Zubiri verfasserin aut Alexander M. Menzies verfasserin aut Douglas B. Johnson verfasserin aut In OncoImmunology Taylor & Francis Group, 2020 12(2023), 1 (DE-627)683365428 (DE-600)2645309-5 2162402X nnns volume:12 year:2023 number:1 https://doi.org/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/article/5fea4b8fffe544958754d98c4b9d90c4 kostenfrei https://www.tandfonline.com/doi/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/toc/2162-402X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 1
allfields_unstemmed	10.1080/2162402X.2023.2188719 doi (DE-627)DOAJ087944367 (DE-599)DOAJ5fea4b8fffe544958754d98c4b9d90c4 DE-627 ger DE-627 rakwb eng RC581-607 RC254-282 Benjamin C. Park verfasserin aut Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon. Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events Immunologic diseases. Allergy Neoplasms. Tumors. Oncology. Including cancer and carcinogens Sathya Narayanan verfasserin aut Alexander Gavralidis verfasserin aut Fei Ye verfasserin aut Run Fan verfasserin aut Ryan J. Sullivan verfasserin aut Genevieve Boland verfasserin aut Kerry L Reynolds verfasserin aut Justin M. Balko verfasserin aut Matteo S. Carlino verfasserin aut Georgina V. Long verfasserin aut Leyre Zubiri verfasserin aut Alexander M. Menzies verfasserin aut Douglas B. Johnson verfasserin aut In OncoImmunology Taylor & Francis Group, 2020 12(2023), 1 (DE-627)683365428 (DE-600)2645309-5 2162402X nnns volume:12 year:2023 number:1 https://doi.org/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/article/5fea4b8fffe544958754d98c4b9d90c4 kostenfrei https://www.tandfonline.com/doi/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/toc/2162-402X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 1
allfieldsGer	10.1080/2162402X.2023.2188719 doi (DE-627)DOAJ087944367 (DE-599)DOAJ5fea4b8fffe544958754d98c4b9d90c4 DE-627 ger DE-627 rakwb eng RC581-607 RC254-282 Benjamin C. Park verfasserin aut Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon. Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events Immunologic diseases. Allergy Neoplasms. Tumors. Oncology. Including cancer and carcinogens Sathya Narayanan verfasserin aut Alexander Gavralidis verfasserin aut Fei Ye verfasserin aut Run Fan verfasserin aut Ryan J. Sullivan verfasserin aut Genevieve Boland verfasserin aut Kerry L Reynolds verfasserin aut Justin M. Balko verfasserin aut Matteo S. Carlino verfasserin aut Georgina V. Long verfasserin aut Leyre Zubiri verfasserin aut Alexander M. Menzies verfasserin aut Douglas B. Johnson verfasserin aut In OncoImmunology Taylor & Francis Group, 2020 12(2023), 1 (DE-627)683365428 (DE-600)2645309-5 2162402X nnns volume:12 year:2023 number:1 https://doi.org/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/article/5fea4b8fffe544958754d98c4b9d90c4 kostenfrei https://www.tandfonline.com/doi/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/toc/2162-402X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 1
allfieldsSound	10.1080/2162402X.2023.2188719 doi (DE-627)DOAJ087944367 (DE-599)DOAJ5fea4b8fffe544958754d98c4b9d90c4 DE-627 ger DE-627 rakwb eng RC581-607 RC254-282 Benjamin C. Park verfasserin aut Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon. Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events Immunologic diseases. Allergy Neoplasms. Tumors. Oncology. Including cancer and carcinogens Sathya Narayanan verfasserin aut Alexander Gavralidis verfasserin aut Fei Ye verfasserin aut Run Fan verfasserin aut Ryan J. Sullivan verfasserin aut Genevieve Boland verfasserin aut Kerry L Reynolds verfasserin aut Justin M. Balko verfasserin aut Matteo S. Carlino verfasserin aut Georgina V. Long verfasserin aut Leyre Zubiri verfasserin aut Alexander M. Menzies verfasserin aut Douglas B. Johnson verfasserin aut In OncoImmunology Taylor & Francis Group, 2020 12(2023), 1 (DE-627)683365428 (DE-600)2645309-5 2162402X nnns volume:12 year:2023 number:1 https://doi.org/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/article/5fea4b8fffe544958754d98c4b9d90c4 kostenfrei https://www.tandfonline.com/doi/10.1080/2162402X.2023.2188719 kostenfrei https://doaj.org/toc/2162-402X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 1
language	English
source	In OncoImmunology 12(2023), 1 volume:12 year:2023 number:1
sourceStr	In OncoImmunology 12(2023), 1 volume:12 year:2023 number:1
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events Immunologic diseases. Allergy Neoplasms. Tumors. Oncology. Including cancer and carcinogens
isfreeaccess_bool	true
container_title	OncoImmunology
authorswithroles_txt_mv	Benjamin C. Park @@aut@@ Sathya Narayanan @@aut@@ Alexander Gavralidis @@aut@@ Fei Ye @@aut@@ Run Fan @@aut@@ Ryan J. Sullivan @@aut@@ Genevieve Boland @@aut@@ Kerry L Reynolds @@aut@@ Justin M. Balko @@aut@@ Matteo S. Carlino @@aut@@ Georgina V. Long @@aut@@ Leyre Zubiri @@aut@@ Alexander M. Menzies @@aut@@ Douglas B. Johnson @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	683365428
id	DOAJ087944367
language_de	englisch
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callnumber-first	R - Medicine
author	Benjamin C. Park
spellingShingle	Benjamin C. Park misc RC581-607 misc RC254-282 misc Immune checkpoint inhibitor toxicity misc immune checkpoint inhibitors misc immune related adverse events misc melanoma misc rare immune related adverse events misc uncommon immune related adverse events misc Immunologic diseases. Allergy misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations
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topic_title	RC581-607 RC254-282 Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations Immune checkpoint inhibitor toxicity immune checkpoint inhibitors immune related adverse events melanoma rare immune related adverse events uncommon immune related adverse events
topic	misc RC581-607 misc RC254-282 misc Immune checkpoint inhibitor toxicity misc immune checkpoint inhibitors misc immune related adverse events misc melanoma misc rare immune related adverse events misc uncommon immune related adverse events misc Immunologic diseases. Allergy misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_unstemmed	misc RC581-607 misc RC254-282 misc Immune checkpoint inhibitor toxicity misc immune checkpoint inhibitors misc immune related adverse events misc melanoma misc rare immune related adverse events misc uncommon immune related adverse events misc Immunologic diseases. Allergy misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_browse	misc RC581-607 misc RC254-282 misc Immune checkpoint inhibitor toxicity misc immune checkpoint inhibitors misc immune related adverse events misc melanoma misc rare immune related adverse events misc uncommon immune related adverse events misc Immunologic diseases. Allergy misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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title	Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations
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title_full	Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations
author_sort	Benjamin C. Park
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author_browse	Benjamin C. Park Sathya Narayanan Alexander Gavralidis Fei Ye Run Fan Ryan J. Sullivan Genevieve Boland Kerry L Reynolds Justin M. Balko Matteo S. Carlino Georgina V. Long Leyre Zubiri Alexander M. Menzies Douglas B. Johnson
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author-letter	Benjamin C. Park
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title_sort	rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations
callnumber	RC581-607
title_auth	Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations
abstract	ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon.
abstractGer	ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon.
abstract_unstemmed	ABSTRACTImmune-related adverse events (irAEs) are side effects of immune checkpoint inhibitor therapy (ICI). While common irAEs have been well characterized, there are more limited data on rare immune related adverse events (RirAEs) due to low incidence. Lack of characterization of these entities has led to difficulties in accurate diagnosis and management. Here, we conducted a multi-institution analysis of all patients with stage III/IV melanoma who developed RirAEs after being treated with ICIs (anti-PD-1/L1, anti-CTLA-4, and combination PD-1/CTLA-4 blockade) at three institutions (Vanderbilt University Medical Center, Massachusetts General Hospital, and Melanoma Institute of Australia). RirAEs were defined as those occurring in approximately <1% of patients treated with anti-PD-1 or <2% with combination. Of 2834 patients who received ICIs, 82 developed RirAEs and were more common with combination PD-1/CTLA-4 blockade (4.6%) vs. anti-PD-1/L1 agents (2.8%). Overall median time from ICI start to RirAE was 86 days (interquartile range 42–235 days) with significantly earlier onset in combination therapy (p < 0.001). The spectrum of RirAEs spanned across several organ systems. Most RirAEs were grade 2 (57 [41.3%]) and grade 3 (40 [29.0%]) with relatively few grade 4 (11 [8.0%]) or 5 (5 [3.6%]) events. Steroid re-escalation (21.4%) or additional immunosuppression (13.8%) were commonly required. RirAE recurrence occurred in 22.6% with ICI rechallenge; 37.1% had new irAEs with rechallenge. In conclusion, RirAEs associated with ICIs in melanoma patients occurred, in aggregate, in 2–5% of patients treated with anti-PD-1-based therapy. Steroid re-escalation and alternative immunosuppression use were frequently required but fatal irAEs were fairly uncommon.
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title_short	Rare immune-related adverse events in patients with melanoma: incidence, spectrum, and clinical presentations
url	https://doi.org/10.1080/2162402X.2023.2188719 https://doaj.org/article/5fea4b8fffe544958754d98c4b9d90c4 https://www.tandfonline.com/doi/10.1080/2162402X.2023.2188719 https://doaj.org/toc/2162-402X
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