Incidence of immune-related adverse events and its association with treatment outcomes: the MD Anderson Cancer Center experience

Takeo Fujii, Rivka R. Colen, Mehmet Asim Bilen, Kenneth R. Hess, Joud Hajjar, Maria E. Suarez-Almazor, Anas Alshawa, David S. Hong, Apostolia Tsimberidou, Filip Janku, Jing Gong, Bettzy Stephen, Vivek Subbiah, Sarina A. Piha-Paul, Siqing Fu, Padmanee Sharma, Tito Mendoza, Anisha Patel, Selvi Thirumurthi, Ajay SheshadriFunda Meric-Bernstam, Aung Naing

Research output: Contribution to journalArticlepeer-review

129 Scopus citations

Abstract

Background Immunotherapy is emerging as the cornerstone for treatment of patients with advanced cancer, but significant toxicity (immune-related adverse events [irAEs]) associated with unbridled T cell activity remains a concern. Patients and methods A retrospective review of the electronic medical records of 290 patients with advanced cancer treated on an immunotherapy-based clinical trial in the Department of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center between February 2010 and September 2015 was performed. Clinical and laboratory parameters were collected to determine the incidence of irAEs, risk factors, and their association with treatment outcomes. Results Ninety eight of 290 patients (34%) experienced any grade irAEs. Among the 15 (5.2%) patients with grade ≥ 3 irAEs, the most common irAEs were dermatitis and enterocolitis. Although 80% of the patients with grade ≥ 3 irAEs required systemic corticosteroids, all the 15 patients recovered from the irAEs. On re-challenge, 4 of the 5 patients who had received systemic corticosteroids for irAE continued to respond. There were no irAE-related deaths. Importantly, patients with grade ≥ 3 irAEs had improved overall response rate (25 vs. 6%; p = 0.039) and longer median time to progression (30 weeks vs. 10 weeks; p = 0.0040) when compared to those without grade ≥ 3 irAEs. Conclusion Incidence of irAEs with immunotherapeutic agents indicates an active immune status, suggestive of potential clinical benefit to the patient. Further validation of this association in a large prospective study is warranted.

Original languageEnglish (US)
Pages (from-to)638-646
Number of pages9
JournalInvestigational New Drugs
Volume36
Issue number4
DOIs
StatePublished - Aug 1 2018

Keywords

  • Checkpoint inhibitors
  • Immune-related adverse event
  • Immunotherapy
  • Response
  • Systemic steroids
  • Time to progression

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)

MD Anderson CCSG core facilities

  • Biostatistics Resource Group

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