Clinical Characteristics of Toxicities of Immune Checkpoint Inhibitors and Their Impact on Efficacy in Solid Cancers: An Analysis of Real-World Data in Moroccan Patients.
Badiaa Batlamous, Sihame Lkhoyaali, Loubna Omri, Magaly-Gwen-Farnely Nguema-Mipaka, Mohamed Khalis, Hanane Inrhaoun, Sarah Naciri, Ibrahim El Ghissassi, Hind Mrabti, Saber Boutayeb, Hassan Errihani
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Abstract
Purpose: Patients receiving immune checkpoint inhibitors (ICIs) may induce immune-related adverse events (irAEs). This study aimed to evaluate the toxicity induced by ICIs and explore the correlation between efficacy and toxicity in a Moroccan population.
Methods: We conducted a prospective study of patients with solid tumors who received pembrolizumab or atezolizumab at the National Institute of Oncology, Rabat from July 2018 to December 2023. We identified irAEs according to ASCO 2021 guidelines and graded them according to the Common Terminology Criteria for Adverse Events Version 4.0. Efficacy with respect to progression-free survival (PFS) and overall survival (OS) was determined. A Cox regression model was used to determine the association between irAEs and survival.
Results: Eighty-six patients with solid tumors who received ICIs were included. The primary tumor types were lung (40.7%), skin (29.1%), and GI cancer (14%). The ICIs most commonly used included pembrolizumab (67.4%) and atezolizumab (32.6%). ICIs were used as monotherapy (77.9%) or in combination (22.1%). A total of 58 (67.4%) patients presented any kind of irAEs. The most common toxicities in both the monotherapy and combination groups were GI, with rates of 25.3% and 31.5%, respectively. Patients with irAEs showed significantly longer median PFS compared with those without irAEs (9 v 3.6 months; hazard ratio [HR], 0.5 [95% CI, 0.32 to 0.99]; P = .04). The median OS was longer in patients with irAEs than in those without irAEs but was not statistically significant (19 v 10.3 months; HR, 0.8 [95% CI, 0.39 to 1.7]; P = .5).
Conclusion: Our results indicated that ICIs have the potential to induce irAEs in patients with solid tumors. These adverse effects were commonly GI. The development of irAEs was associated with improved effectiveness of ICI treatment across different malignancies.
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