Cutaneous immune-related adverse events as positive indicators of overall survival after cancer immunotherapy

February 2022 Science Nalinee Pathak

Immunotherapy is at the forefront of cancer treatment. However, there is still a high percentage of patients who do not either respond to immune checkpoint inhibitors (ICIs) or show immune-related adverse events upon ICI treatments.

Immune-related adverse events of ICI include cutaneous immune-related adverse events (cirAEs), observed in around 20-40% of patients treated with ICIs. A recent study by Tang et al. has studied the association of these cirAEs with survival outcomes in patients treated with immunotherapy. The findings of this study were recently published in JAMA Dermatology.

This retrospective cohort study has performed population-level cohort analysis on the TriNetX Diamond Network database constituted data from 200 million US and European patients. This case-control study included 7,008 patients who developed cirAEs after receiving immunotherapy for cancer of digestive organs, bronchus or lung, melanoma of the skin, and urinary tract, along with 7,008 matched controls. Patient characteristics were well balanced between both groups with a mean age of 68 years and 43% women.

Protective outcomes with cutaneous AE

The Cox proportional hazard model was used to analyze the association of cirAEs with overall survival (OS). The six-month analysis observed that the development of pruritus (hazard ratio [HR], 0.695; 95% CI, 0.602-0.803; P<0.001), drug eruption (HR, 0.755; 95% CI, 0.635-0.897; P=0.001), xerosis (HR, 0.626; 95% CI, 0.469-0.834; P=0.001), nonspecific rashes (HR, 0.704; 95% CI, 0.634-0.781; P<0.001), and appearance of any cirAE (HR, 0.778; 95% CI, 0.726-0.834; P<0.001) were significantly protective of mortality. Additionally, Eczematous dermatitis (HR, 0.612; 95% CI, 0.314-1.195), vitiligo (HR, 0.534; 95% CI, 0.254-1.123), bullous pemphigoid (HR, 0.524; 95% CI, 0.140-1.956), and Grover disease (HR, 0.468; 95% CI, 0.115-1.898) were also associated with protective clinical outcomes.

Conclusion

The case-control retrospective study demonstrated that the cirAEs are strong indicators of survival and response to immunotherapy.

Reference

Tang K, Seo J, Tiu BC, et al. Association of Cutaneous Immune-Related Adverse Events With Increased Survival in Patients Treated With Anti-Programmed Cell Death 1 and Anti-Programmed Cell Death Ligand 1 Therapy. JAMA Dermatol. 2022 Jan 12:e215476

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