Palliative and Supportive Care Symposium: Immunotherapy-Related Toxicities
Posted: Tuesday, November 27, 2018
An analysis of patients with non–small cell lung cancer (NSCLC) who were treated with immune checkpoint inhibitors found that the frequency of immune-related adverse events may be higher than reported in the initial trials that led to approval of these therapies. The results of the study were presented at the 2018 Palliative and Supportive Care Symposium in San Diego (Abstract 184).
“We believe that our study is the first to look at adverse events based on claims data, which gives a much broader, population-based perspective on outcomes than a single trial,” stated senior study author Elizabeth Jane Cathcart-Rake, MD, of Mayo Clinic, Rochester, Minnesota, in an American Society of Clinical Oncology press release. “While there have been studies comparing data from multiple trials, our approach includes a comprehensive look at outcomes for most insured patients.”
The researchers reviewed claims data from a large U.S. commercial insurance database to identify 2,798 patients with NSCLC who received nivolumab (71.4%), pembrolizumab (25%), or atezolizumab (3.6%). They determined the frequency of immune-related adverse events by identifying new medical claims during the time period of immunotherapy. The most common immune-related adverse outcome, hypothyroidism, occurred in 9.2% of patients; anemia and acute kidney injury occurred in 5.7% and 2.8% of patients, respectively.
An example of the variability in frequency of immune-related events is found in the KEYNOTE-24 trial, which compared pembrolizumab versus chemotherapy. Hypophysitis was noted to occur in 0.6% of participants in the KEYNOTE-24 trial, whereas this larger cohort identified the condition in 2.4% of patients. Analyses of the data are ongoing to give researchers a better understanding of the absolute differences between trial-reported toxicities and those seen in the population at large.
