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Journal of Cancer Research and Clinical Oncology

Erschienen in:

08.08.2023 | Research

Immune checkpoint inhibitor-associated adrenal insufficiency in Chinese cancer patients: a retrospective analysis

verfasst von: Qingqing Cai, Wei Wu, Xiaoyu Li, Qing Xu, Lin Zhao, Qianzhou Lv

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 15/2023

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Abstract

Purpose

Immune checkpoint inhibitors (ICIs) are of great success in cancer therapy. This study aimed to identify adrenal insufficiency (AI) associated with immune checkpoint inhibitor (ICI) treatment in cancer patients receiving steroid replacement therapy and report the clinical characteristics of ICI-associated AI and concurrent immune-associated adverse events (irAEs).

Methods

Patients prescribed cortisone acetate between January 2020 and March 2022 were reviewed to identify AI associated with ICI treatment. Data collected included indication of ICI (cancer type), drug characteristics, and outcomes.

Results

A total of 101 patients were diagnosed with AI following treatment with ICIs. The median age was 64 years (range 22-83 years); 73.3% of the patients were male. Median time to develop primary AI and secondary AI after starting ICI therapy was 200.5 (35-280) days and 178 (16-562) days, respectively. Concurrent irAEs occurred in 67 (66.3%) patients and included 63 (62.4%) endocrine irAEs. Log-rank test showed that there was a trend toward higher likelihood of death at 120-day follow-up in patients initially receiving intravenous hydrocortisone compared with those receiving oral cortisone acetate after diagnosis of AI (p = 0.029).

Conclusion

This retrospective study comprehensively documented the clinical characterization of ICI-associated AI. Those initially receiving intravenous hydrocortisone after diagnosis of AI were associated with higher likelihood of death. Physicians should be aware of the variability of ICI-associated irAEs early in the treatment, early diagnoses, and timely management should be made.

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Titel: Immune checkpoint inhibitor-associated adrenal insufficiency in Chinese cancer patients: a retrospective analysis
verfasst von: Qingqing Cai
Wei Wu
Xiaoyu Li
Qing Xu
Lin Zhao
Qianzhou Lv
Publikationsdatum: 08.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 15/2023
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-023-05093-3

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Immune checkpoint inhibitor-associated adrenal insufficiency in Chinese cancer patients: a retrospective analysis