Cutaneous Immune-Related Adverse Events and Efficacy of Immune Checkpoint Inhibitors for Patients With Advanced Solid Organ Malignancies.

Abstract

Introduction: Immune checkpoint inhibitors (ICIs) have significantly improved outcomes for patients with advanced solid tumors. While low-grade immune-related adverse events (irAEs) are associated with prolonged survival, high-grade irAEs have been associated with poorer survival. Cutaneous immune-related adverse events (cirAEs) affect up to 20%-40% of patients treated with ICIs. We investigated the association between cirAES and the outcomes of progression-free survival (PFS) and overall survival (OS) in advanced solid organ malignancies.

Methods: A retrospective analysis of patients receiving ICIs for stage IV solid organ malignancies was conducted at Beaumont RCSI Cancer Centre, Dublin, Ireland, between January 1, 2012, and June 30, 2020. Eligible participants included those who commenced therapy during this period, having received at least one cycle of ICI treatment, with or without chemotherapy, for histologically confirmed advanced solid organ malignancies.

Results: Among 278 analyzed patients, 19% (53/278) experienced any cirAES. The most common cirAEs included psoriasis (23%) and pruritus (15%). cirAES were associated with significantly improved PFS (median 47.3 months vs. 18.3 months, p < 0.01) and OS (median 60.0 months vs. 26.0 months, p < 0.01). Patients with prior systemic therapy had a decreased risk of cirAES (odds ratio = 0.44, p = 0.02), and multivariate analysis confirmed that cirAES was independently associated with improved PFS and OS.

Conclusion: Our study supports that cirAES may be associated with improved patient outcomes and that prior systemic therapy may be associated with a reduced risk of cirAES. Future research should focus on multi-institutional collaborations based on prospective irAE data to better understand the impact of specific irAEs on clinical outcomes.