Immune-Related Adverse Events Due to Checkpoint Inhibition Are More Common in Melanoma Than in NSCLC

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Researchers investigated whether the rates of immune-related adverse events linked to treatment with nivolumab or pembrolizumab were similar across 2 different cancer types.
Researchers investigated whether the rates of immune-related adverse events linked to treatment with nivolumab or pembrolizumab were similar across 2 different cancer types.
The following article features coverage from the European Society for Medical Oncology (ESMO) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

More patients with melanoma who were treated with either nivolumab or pembrolizumab developed immune-related adverse events (irAEs) compared with patients with non-small cell lung cancer (NSCLC) treated with these same checkpoint inhibitors, suggesting differences in these events across groups. However, more studies will be needed to determine whether the association between irAEs and cancer type is related to tumor characteristics, differences in the anti-PD-1 agent used, or other factors.

These data will be presented as a poster during the 2018 ESMO Congress in Munich, Germany.1

According to the abstract, irAEs are a treatment challenge of immunotherapies that could potentially limit their clinical benefit. In this study, researchers examined the occurrence of irAEs related to treatment with an anti-PD-1 drug — nivolumab or pembrolizumab —  seen in 266 patients with melanoma compared with those observed in 244 patients with NSCLC. All of the subjects were treated at the Mayo Clinic in either Rochester, Minnesota, or Jacksonville, Florida, from 2015 to 2018.

Three-quarters of patients with melanoma were treated with pembrolizumab and 66% of patients with NSCLC received nivolumab. More than one-half of patients (55%) with melanoma experienced an irAE compared with only 41% of patients with NSCLC (P <. 001). However, no difference in grade 3 or higher irAEs was seen between the 2 cancer types.

Specifically, patients with melanoma were more likely to develop diarrhea/colitis (19% vs 7%; P < .008) and endocrinopathies (33% vs 18%; P < .01) compared with patients with NSCLC. In contrast, patients with NSCLC were more likely to develop pneumonitis (14% vs 6%; P < .007).

More than half of patients with melanoma (60%) and NSCLC (57%) resumed treatment with PD-1 inhibitors after developing irAEs. However, 45% of patients with melanoma and 31% of those with NSCLC ultimately discontinued use of the immunomodulator due to toxicity.

Read more of Cancer Therapy Advisor's coverage of the ESMO 2018 meeting by visiting the conference page.

Reference

  1. Duma N. Immune-related adverse events: Comparison of melanoma and non-small cell lung cancer patients treated with anti-PD1 therapy. Abstract presented at: the ESMO 2018 Congress; Munich, Germany: October 20, 2018. Abstract 1218P.

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