|The following article features coverage from the European Society for Medical Oncology (ESMO) 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
Immune checkpoint inhibitor (ICI) immune-related adverse events (irAEs) are common and are associated with treatment discontinuation and patient deaths, according to a real-world observational study of hospital admissions that was presented at the European Society of Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain.
“Approximately half of patients receiving an ICI experienced an irAE that required clinical management in inpatient or outpatient setting,” reported the study authors within the abstract. “Occurrence of irAEs was associated with treatment discontinuation. Overall, irAE cases with inpatient index visits tended to have poor outcomes and required more follow-up management.”
Immunotherapies are increasingly common treatments for cancer patients in academic cancer center and community settings. The study authors sought to assess real-world irAE experiences among hospital patients. Using the Premier Healthcare Database of hospital records between March 2015 and December 2017, the authors identified patients with diagnoses of non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), urothelial carcinoma (UC), and Merkel cell carcinoma (MCC); and who were administered ICI therapy and had at least 1 of 28 irAEs. Patients’ irAE-related inpatient admissions, in-hospital mortality, and ICI re-initiation were then assessed.
More than 15,000 distinct irAEs were found for 13,030 patients. Of 6590 patients with 1 or more irAE, 44% had 1 irAE, 25% had 2, 14% had 3 irAEs, and 17% had 4 or more irAEs. Myocarditis, transverse myelitis, and toxic epidermal necrolysis were the most common irAEs.
Patients with irAEs had higher subsequent inpatient hospitalizations and higher mortality, and lower ICI re-initiation rates (P <.001). Within 90 days of an irAE, patients who were hospitalized as inpatients had a 23% mortality rate compared with 6% of outpatients, and 70% of inpatient-hospitalized patients failed to re-initiate ICI, compared with 28% of outpatients.
Disclosure: The study was funded by EMD Serono, Inc., a subsidiary of Merck Healthcare KGaA. For a full list of author disclosures, please refer to the abstract.
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George S, Zheng Y, Kim R, et al. Real-world outcomes of immune-related adverse events (irAEs) among patients receiving immune checkpoint inhibitors (ICIs) in hospital settings. Presented at: European Society of Medical Oncology (ESMO) Congress 2019; September 27-October 1, 2019: Barcelona, Spain. Abstract 1284P.