Demographic Variations in Immune Checkpoint Inhibitor Adverse Events: A Real-World Study.

IF 2.2 Q3 ONCOLOGY

World Journal of Oncology Pub Date : 2025-08-19 eCollection Date: 2025-10-01 DOI:10.14740/wjon2612

Shreya Shambhavi, Mariela DiVanna, Shubhangi Sharma, Harmanjeet Singh, Arushi Gupta, Tiffany Pompa, Adam Kaplan, Jose Iglesias

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引用次数: 0

Abstract

Background: Immune checkpoint inhibitors (ICIs) have caused a paradigm shift in cancer therapy, but the resultant immune activation also precipitates autoimmune toxicities termed immune-related adverse events (irAEs). However, system-specific analyses of irAEs remain limited, particularly their variation with body mass index (BMI), race, sex, age, and type of ICI.

Methods: A retrospective analysis was conducted on 244 patients who developed irAEs after receiving ICI. Among the study population, 58% were female; the racial and ethnic distribution was 84% White, 13% Hispanic, 2% African American, and 1% Asian; and the age breakdown was 23% under 65 years, 38% between 65 and 79 years, and 39% over 80 years. Univariate analysis was performed employing the Chi-square test. Multivariable logistic regression and cluster analyses revealed distinct irAE predictors.

Results: Univariate analysis (Chi-square) showed significant associations between BMI and pneumonitis (P = 0.02) and between race and hepatitis (P = 0.04), but these did not persist in multivariate regression. No significant correlations were found between thyroiditis or colitis and sex, race, BMI, age, or immunotherapy type. Increasing age was protective against neutropenia, with significantly lower risk in patients aged 65 - 79 (odds ratio (OR) 0.38, P = 0.007) and ≥ 80 years (OR 0.18, P < 0.001); African Americans were at higher risk (OR 10.29, P = 0.02), and male sex was protective (OR 0.51, P = 0.03). Anemia was less frequent in those ≥ 80 years (OR 0.48, P = 0.03) and Hispanics (OR 0.4, P = 0.03). Thrombocytopenia risk was reduced in patients aged 65 - 79 (OR 0.41, P = 0.03) and ≥ 80 (OR 0.36, P < 0.001). Cluster analysis showed higher irAE rates in patients treated with nivolumab (alone or with ipilimumab) compared to pembrolizumab.

Conclusion: Advanced age showed a protective effect on cytopenias. Hispanics had reduced anemia and dermatitis risk; African Americans and females had higher neutropenia, and obesity was linked to dermatitis. These findings may aid clinicians in personalizing ICI counseling and recognizing at-risk groups.

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免疫检查点抑制剂不良事件的人口统计学变化：一项真实世界的研究。

背景：免疫检查点抑制剂（ICIs）已经引起了癌症治疗的范式转变，但由此产生的免疫激活也会引发称为免疫相关不良事件（irAEs）的自身免疫性毒性。然而，对irae的系统特异性分析仍然有限，特别是它们随体重指数（BMI）、种族、性别、年龄和ICI类型的变化。方法：对244例接受体外循环治疗后发生irae的患者进行回顾性分析。在研究人群中，58%为女性；种族和民族分布为白人84%，西班牙裔13%，非洲裔2%，亚裔1%；65岁以下占23%，65 - 79岁占38%，80岁以上占39%。采用卡方检验进行单因素分析。多变量逻辑回归和聚类分析揭示了不同的irAE预测因子。结果：单因素分析（卡方分析）显示BMI与肺炎（P = 0.02）、种族与肝炎（P = 0.04）之间存在显著关联，但这些在多因素回归中并未持续存在。甲状腺炎或结肠炎与性别、种族、体重指数、年龄或免疫治疗类型没有显著相关性。年龄增加对中性粒细胞减少症有保护作用，65 - 79岁（优势比（OR） 0.38, P = 0.007）和≥80岁（OR 0.18, P < 0.001）患者的风险显著降低；非裔美国人患病风险较高（OR 10.29, P = 0.02），男性具有保护作用（OR 0.51, P = 0.03）。在≥80岁的人群中（OR 0.48, P = 0.03）和西班牙裔人群中（OR 0.4, P = 0.03）贫血发生率较低。65 - 79岁（OR 0.41, P = 0.03）和≥80岁（OR 0.36, P < 0.001）患者的血小板减少风险降低。聚类分析显示，与派姆单抗相比，接受纳武单抗（单独或联合伊匹单抗）治疗的患者的irAE发生率更高。结论：高龄对细胞减少有保护作用。拉美裔人患贫血和皮炎的风险较低；非裔美国人和女性有较高的中性粒细胞减少症，肥胖与皮炎有关。这些发现可能有助于临床医生个性化ICI咨询和识别高危人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Oncology ONCOLOGY-

CiteScore

6.10

自引率

15.40%

发文量

期刊介绍： World Journal of Oncology, bimonthly, publishes original contributions describing basic research and clinical investigation of cancer, on the cellular, molecular, prevention, diagnosis, therapy and prognosis aspects. The submissions can be basic research or clinical investigation oriented. This journal welcomes those submissions focused on the clinical trials of new treatment modalities for cancer, and those submissions focused on molecular or cellular research of the oncology pathogenesis. Case reports submitted for consideration of publication should explore either a novel genomic event/description or a new safety signal from an oncolytic agent. The areas of interested manuscripts are these disciplines: tumor immunology and immunotherapy; cancer molecular pharmacology and chemotherapy; drug sensitivity and resistance; cancer epidemiology; clinical trials; cancer pathology; radiobiology and radiation oncology; solid tumor oncology; hematological malignancies; surgical oncology; pediatric oncology; molecular oncology and cancer genes; gene therapy; cancer endocrinology; cancer metastasis; prevention and diagnosis of cancer; other cancer related subjects. The types of manuscripts accepted are original article, review, editorial, short communication, case report, letter to the editor, book review.