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Predictors of Immunotherapy-Induced Immune-Related Adverse Events

Department of Medicine, Queen’s University, Sydenham 3, Room 013-2, Hotel Dieu Hospital, 166 Brock Street, Kingston, ON K7L 5G2, Canada
Hotel Dieu Hospital, Kingston, ON, Canada
Cancer Centre of Southeastern Ontario, Kingston, ON, Canada
Department of Endocrinology, Queen’s University, Kingston, ON, Canada
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(5), 403-410;
Submission received: 7 July 2018 / Revised: 11 August 2018 / Accepted: 8 September 2018 / Published: 1 October 2018


Purpose: We aimed to elucidate predictive factors for the development of immune-related adverse events (iraes) in patients receiving immunotherapies for the management of advanced solid cancers. Methods: This retrospective study involved all patients with histologically confirmed metastatic or inoperable melanoma, non-small-cell lung cancer, or renal cell carcinoma receiving immunotherapy at the Cancer Centre of Southeastern Ontario. The type and severity of iraes, as well as potential protective and exacerbating factors, were collected from patient charts. Results: The study included 78 patients receiving ipilimumab (32%), nivolumab (33%), or pembrolizumab (35%). Melanoma, non-small-cell lung cancer, and renal cell carcinoma accounted for 70%, 22%, and 8% of the cancers in the study population. In 41 patients (53%) iraes developed, with multiple iraes developing in 12 patients (15%). In most patients (70%), the iraes were of severity grade 1 or 2. Female sex [adjusted odds ratio (oradj): 0.094; 95% confidence interval (ci): 0.021 to 0.415; p = 0.002] and corticosteroid use before immunotherapy (oradj: 0.143; 95% ci: 0.036 to 0.562; p = 0.005) were found to be associated with a protective effect against iraes. In contrast, a history of autoimmune disease (oradj: 9.55; 95% ci: 1.34 to 68.22; p = 0.025), use of ctla-4 inhibitors (oradj: 6.25; 95% ci: 1.61 to 24.25; p = 0.008), and poor kidney function of grade 3 or greater (oradj: 10.66; 95% ci: 2.41 to 47.12; p = 0.025) were associated with a higher risk of developing iraes. A Hosmer–Lemeshow goodness-of-fit test demonstrated that the logistic regression model was effective at predicting the development of iraes (chi-square: 1.596; df = 7; p = 0.979). Conclusions: Our study highlights several factors that affect the development of iraes in patients receiving immunotherapy. Although future studies are needed to validate the resulting model, findings from the study can help to guide risk stratification, monitoring, and management of iraes in patients given immunotherapy for advanced cancer.
Keywords: predictors; immunotherapy; immune-related adverse events; advanced solid cancers predictors; immunotherapy; immune-related adverse events; advanced solid cancers

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MDPI and ACS Style

Kartolo, A.; Sattar, J.; Sahai, V.; Baetz, T.; Lakoff, J.M. Predictors of Immunotherapy-Induced Immune-Related Adverse Events. Curr. Oncol. 2018, 25, 403-410.

AMA Style

Kartolo A, Sattar J, Sahai V, Baetz T, Lakoff JM. Predictors of Immunotherapy-Induced Immune-Related Adverse Events. Current Oncology. 2018; 25(5):403-410.

Chicago/Turabian Style

Kartolo, A., J. Sattar, V. Sahai, T. Baetz, and Joshua Matthew Lakoff. 2018. "Predictors of Immunotherapy-Induced Immune-Related Adverse Events" Current Oncology 25, no. 5: 403-410.

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