A study about the immune-related side effects at SAMOC : incidence, grades of toxicity & relation to past treatment and radiotherapy

Abstract

BACKGROUND: Immunotherapy targeting cytotoxic T-lymphocyte associated antigen 4 (CTLA4) and the programmed death receptor (PD-1) and its ligand (PDL1) is becoming the standard of care for many malignancies. Hence, the number of patients on immunotherapy is increasing as is the probability of developing toxicities secondary to these treatments. This project mainly aims to look at the frequency of ir-AEs at Sir Anthony Mamo Oncology Centre Malta between June 2016 and June 2020.

METHOD: A cohort of 177 patients were treated with immunotherapy between June 2016 and June 2020 at Sir Anthony Mamo Oncology Centre. These were assessed for immunotherapy related toxicities. These individuals were assessed for the following: age, gender, malignancy diagnosed, immunotherapeutic agents (single or combination therapy) used, systemic anticancer therapy exposure prior to ICI therapy (namely chemotherapy and TKIs), concomitant/ concurrent radiotherapy (radical and palliative RT), line of treatment at which ICI therapy was administered, the CTCAE grade and frequency of Ir-AEs studied.

RESULTS: Adverse events occurred in 43.6% of the cohort and none were recorded for 56.4%. The most common ir-AEs in our cohort were dermatological AEs (8%), thyroid-related AEs (19.4%), hepatic AEs (8%) and GI AEs (9.2%). Other data was collected and discussed further below.

CONCLUSION: The increasing use of immunotherapy for various cancer sites with immune checkpoint inhibitors has resulted in positive primary treatment outcomes. Secondarily, immune-related adverse events have been widely observed, as seen in the cohort assessed for all types of Ir-AEs in this study.