Open AccessImmune checkpoint inhibitor‐related adverse events in lung cancer: Real‐world incidence and management practices of 1905 patients in China
Author(s) -
Shi Yuequan,
Fang Jian,
Zhou Chengzhi,
Liu Anwen,
Wang Yan,
Meng Qingwei,
Ding Cuimin,
Ai Bin,
Gu Yangchun,
Yao Yu,
Sun Hong,
Guo Hui,
Zhang Cuiying,
Song Xia,
Li Junling,
Xu Bei,
Han Zhiqiang,
Song Meijun,
Tang Tingyu,
Chen Peifeng,
Lu Hongmin,
Shui Yongjie,
Lou Guangyuan,
Zhang Dongming,
Liu Jia,
Liu Xiaoyan,
Liu Xiangning,
Gao Xiaoxing,
Zhou Qing,
Chen Minjiang,
Zhao Jing,
Zhong Wei,
Xu Yan,
Wang Mengzhao
Publication year - 2022
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.14274
Subject(s) - medicine , lung cancer , adverse effect , incidence (geometry) , pneumonitis , cancer , oncology , lung , physics , optics
Background Immune checkpoint inhibitors (ICIs) are the standard treatment for advanced lung cancer, but immune‐related adverse events (irAEs) remain poorly understood, especially in a real‐world setting. Methods A multicenter observational study was conducted. Medical records of lung cancer patients treated with ICIs at 26 hospitals from January 1, 2015, to February 28, 2021, were retrieved. Types of ICIs included antiprogrammed cell death 1 or antiprogrammed cell death ligand 1 (PD‐L1) monotherapy, anticytotoxic T‐lymphocyte antigen‐4 monotherapy, or combination therapy. Results In total, 1905 patients with advanced lung cancer were evaluated. The median age was 63 (range 28–87) years, and the male/female ratio was 3.1:1 (1442/463). The primary histological subtype was adenocarcinoma (915). A total of 26.9% (512/1905) of the patients developed 671 irAEs, and 5.8% (110/1905) developed 120 grade 3–5 irAEs. Median duration from ICI initiation to irAEs onset was 56 (range 0–1160) days. The most common irAEs were thyroid dysfunction (7.2%, 138/1905), pneumonitis (6.5%, 124/1905), and dermatological toxicities (6.0%, 115/1905). A total of 162 irAEs were treated with steroids and 11 irAEs led to death. Patients with positive PD‐L1 expression (≥1%) and who received first‐line ICI treatment developed more irAEs. Patients who developed irAEs had a better disease control rate (DCR, 71.3% [365/512] vs. 56.0% [780/1145]; p < 0.001). Conclusions The incidence rate of irAEs was 26.9% in a real‐world setting. IrAEs might be related to a better DCR, but clinicians should be more aware of irAE recognition and management in clinical practice.