Background and importance Inmunotherapy has changed the ladscape of cancer treatment in recent years. Among them, immune checkpoint inhibitors are increasingly used for certain cancers; however, this has resulted in increased reports of immune-related adverse events (irAEs).
Aim and objectives Identify the irAEs, their gravity, management and appearance time, according to treatment and pathology.
Material and methods Retrospective, descriptive study of patients treated with methylprednisolone, mycophenolate mofetil and infliximab in the last 5 years (2017–2021) after presenting irAEs. The variables collected were: sex, age, weight, pathology, inmunotherapy, grade, type, management and appearance time of toxicity, continuation or suspension of treatment.
Results The total number of patients who presented irAEs was 52 (52% men) of a total of 612 patients treated with it in the study period. Medium age was 61(39–88) years, weight 67±10 kg. Seventy-five percent of patients suffered from non-small-cell lung cancer, 21% melanoma, 2% bladder and 2% kidney cancer. 69% received pembrolizumab, 11% nivolumab, 8% atezolizumab, 6% ipilimumab, 4% nivolumab/ipilimumab and 2% durvalumab.
Fifty-two percent presented irAEs grade 2; 31% grade 3; 9% grade 4, the rest being unknown. 25% showed nephrotoxicity as an adverse effect; 23% hepatitis, 23% diarrhoea, 9% pneumonitis, 8% colitis, 4% thyroiditis, 4% pancreatitis, 2% pericardial effusion and 2% oesophagitis. 75% of patients received a decreased regimen of oral methylprednisolone for 15 days, 15% unique intravenous dose of infliximab 5 mg/kg and 10% mycophenolate mofetil for 60±15 days.
In about 71% of patients, irAEs were found during the first line treatment, 27% in the second and 2% in the sixth. Median days until appearance was 58 (16–644) days.
Sixty percent continued their inmunotherapy and in 40% this was stopped.
Conclusion and relevance Inmunotherapy drugs can occasionally cause some adverse effects. In our study the most common one was nephrotoxicity due to pembrolizumab. Despite this, most patients continued treatment once the adverse event was resolved. As reported in some guides, the majority of irAEs were solved using methylprednisolone. More studies are needed based on obtaining more specific conclusions.
Conflict of interest No conflict of interest
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