medwireNews: Cutaneous immune-related adverse events (cirAEs) are associated with a reduced risk for death among cancer patients with immune checkpoint inhibitors (ICIs), research suggests.
“This cohort study suggests that cirAE development is a favorable clinical indicator and warrants further investigation into its underlying immunopathogenesis, which may provide further insights into immunotherapy response,” say Yevgeniy Semenov (Harvard Medical School, Boston, Massachusetts, USA) and team in JAMA Dermatology.
They used the TriNetX Diamond Network, a health records and claims database, to identify 7008 patients who developed cirAEs within 6 months of receiving anti-PD-1 or anti-PD-L1 treatment for melanoma or for malignant neoplasms of the digestive organs, bronchus and lung, or urinary tract. These patients were matched by propensity score and the presence of distant metastases to 7008 individuals who did not experience any cirAEs.
A 6-month landmark analysis revealed an association between the development of cirAEs and a reduced risk for death, with a significant hazard ratio (HR) of 0.778 after adjusting for multiple comparisons using the Benjamini–Hochberg (BH) correction.
The study authors also investigated individual cirAE types, finding that xerosis, pruritis, nonspecific rashes, and drug eruption were significantly associated with a decreased mortality risk after BH correction, at HRs of 0.626, 0.695, 0.704, and 0.755, respectively.
Lichen planus and psoriasis were also associated with a significantly reduced risk for mortality, with HRs of 0.511 and 0.703, respectively, “but did not meet the BH correction for multiple comparisons,” say the researchers. And there was a nonsignificant trend towards a reduced risk for death for eczematous dermatitis, vitiligo, bullous pemphigoid, and Grover disease.
Semenov et al highlight that hyperhidrosis and mucositis were the only cirAEs that did not show “a clinically protective effect” in this study.
“The lack of achieved statistical significance among some dermatoses is likely because of the insufficient sample size of rarer diagnoses and few observed deaths in these subgroups during the study follow-up,” they continue.
The team concludes: “Additional studies are needed to assess the association of cirAE management with survival outcomes and whether ICI therapy interruption or discontinuation in the setting of these toxic effects is clinically warranted or associated with overall survival.”
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