Immune-related adverse events associated with immune checkpoint inhibitors in patients with cancer.
INTRODUCTION
With the widespread use of immune checkpoint inhibitors (ICIs), we are facing challenges in the management of immune-related adverse events (irAEs). We aimed to characterize the spectrum of toxicity, management, and outcomes for irAEs.


METHODS
Patients who were treated with at least one ICI in clinical trials, expanded access programs, or routine clinical practice were included. Clinical and laboratory parameters were collected retrospectively to determine the incidence of irAEs, methods of management, and treatment outcomes.


RESULTS
A total of 255 patients were screened retrospectively. Of these, 71 (27.8%) patients developed irAEs. More than 2 different types of irAEs were detected in 16 (6.2%) out of 255 patients. A total of 3177 doses were given to 255 patients. In 93 (2.9%) of the 3177 doses, 1 episode of irAEs was experienced. A total of 22 out of 93 (23.7%) episodes were reported as grade 1, 49 (52.7%) as grade 2, 19 (20.4%) as grade 3, and 3 (3.2%) as grade 4. The most frequently seen irAEs were pneumonitis, hepatitis, and hypothyroidism. With regard to treatment, 39 out of 93 episodes (42%) of any grade irAEs occurred after anti-programmed cell death-1 therapy, 47 (50.5%) occurred following administration of anti-programmed death-ligand 1, and 7 (7.5%) occurred after combination treatments.


CONCLUSION
With the increased use of immunotherapeutic agents, increased awareness and early recognition are required for effective management of irAEs. Our experience as a single institution might be of use for health care providers in oncology.
['Sengul Samanci|Nilay|N|https://orcid.org/0000-0003-4966-3561', 'Cikman|Duygu Ilke|DI|', 'Oruc|Kerem|K|', 'Bedir|Sahin|S|', 'Çelik|Emir|E|', 'Degerli|Ezgi|E|', 'Derin|Sumeyra|S|', 'Demirelli|Fuat Hulusi|FH|', 'Özgüroğlu|Mustafa|M|']
D000328:Adult D000368:Aged D064420:Drug-Related Side Effects and Adverse Reactions D005260:Female D005500:Follow-Up Studies D006801:Humans D000082082:Immune Checkpoint Inhibitors D008297:Male D008875:Middle Aged D009369:Neoplasms D011379:Prognosis D012189:Retrospective Studies D055815:Young Adult
immune-related adverse events immune checkpoint inhibitors Cancer