Association of immune-related adverse events with immune-checkpoint inhibitors and treatment response in melanoma patients.

Authors

null

Benigno Rodriguez

The American British Cowdray Medical Center, Mexico City, Mexico

Benigno Rodriguez , José Fabián Martínez-Herrera , Lorena López Zepeda , Guillermo Olivares , Alberto Villalobos , Fernando Perez , Christian Patricio Camacho Limas , Juan Alberto Serrano , Omar Serrano Villamayor , Ervin Saúl Enciso López , Daniela Shveid Gerson , Efrain Isaias Camarin Sanchez , Diana Bonilla Molina , Juan Manuel Tovar Cabrera , Cecilia Nehmad , Juan Jose Juarez - Vignon Whaley , Raquel Gerson

Organizations

The American British Cowdray Medical Center, Mexico City, Mexico, The American British Cowdray Medical Center, Ciudad De México, Mexico, The American British Cowdray Medical Center, Mexico City, DF, Mexico, Centro Medico ABC y Hospital Angeles Lomas, Mexico, Mexico, American British Cowdray Medical Center, Mexico City, DF, Mexico, Centro Médico ABC, Mexico City, Mexico, The American British Cowdray Medical Center, Mexico, DF, Mexico, American British Cowdray Medical Center, Ciudad De México, DF, Mexico, Instituto Nacional de Enfermedades Respiratorias, State of Mexico, Mexico

Research Funding

No funding received

Background: Immune-related adverse effects (irAE´s) of immune-checkpoint inhibitors (ICIs) have been linked with a better treatment response in melanoma patients, especially cutaneous toxicities. However, little is known regarding other irAE´s which is important as they can be used as clinical markers of an adequate therapeutical response. Methods: We conducted a retrospective study on patients who were diagnosed with melanoma and received treatment with ICI´s between January 2015 until December 2021, immune related adverse events and their relationship with overall survival in melanoma patients treated with ICIs was the main objective of this study. Results: 53 records of patients with advance melanoma treated with ICIs between january 2016 to december 2021, demographic characteristics were as follow: 64.2% were male, mean age at diagnoses was 60.3 years, 41.5% had smoking history and 15.1% were Jewish. At diagnosis 73.6% of patients had a good functional status (ECOG 0-1). The most common histological subtypes were epithelioid (34%), and nodular (22.6%). Lung metastases was the most common affected site (49.1%), followed by brain 43.4% and non-regional nodes 42.5%. BRAF mutations was determined in 81.1% of the biopsies and 36% of them being V600E mutation. ICI´s was the preferred first line treatment in 83% of cases, median number of administered cycles were 6 (range 1-54 cycles), 60.4% of patients received pembrolizumab, 37.7% nivolumab plus ipilimumab, 20.8% nivolumab monotherapy and 5.7% ipilimumab. Throughout the studied period IrAE´s were reported in 34% of patients with 66.7% of them being grade 1-2 and 33.3% grade 3-4. The most common IrAE’s: vitiligo 38.8%, hypothyroidism22% and 3.8% pneumonitis. Median PFS at 12 months and OS was significantly better in the group of patients with irAE´s: Patients who develop an irAE´s are 7 times more likely to be disease free at 12 months and 4.1 times more likely to have a longer OS regardless of severity and type of toxicity. The impact of developing irAEs is significantly important for PFS (HR: 11.9, CI 95%: 3.28-4.71) as median PFS was not yet reached in this group. Conclusions: Development of irAEs is associated with favorable outcomes to ICIs with patients being 7 times more likely to be 12-month disease free and 4.1 times more likely to have a longer OS. irAEs can be used as clinical markers of an adequate treatment response.

Overall survival and irAE´s.


irAE´s presented
irAE´s not presented
Log-rank test
Median Overall survival
40.67 months
12.9 months
11.2 p = 0.001

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e21522)

DOI

10.1200/JCO.2022.40.16_suppl.e21522

Abstract #

e21522

Abstract Disclosures