Toxicity profile of treatment with PD-1 inhibitors for lung cancer, melanoma and renal cell carcinoma: A real-world Brazilian study

Int Immunopharmacol. 2022 Jul:108:108727. doi: 10.1016/j.intimp.2022.108727. Epub 2022 Apr 6.

Abstract

Introduction: Immunotherapy revolutionized cancer care in the last decade and, notably among its tools, the programmed cell death protein-1 (PD-1) inhibitors. These drugs are related to increased life expectancy rates. However, they can cause several adverse events that have not been fully characterized, thus challenging clinical practice.

Objective: To evaluate the toxicity profile, determining its frequency, causality, and severity associated with treatment with PD-1 inhibitors in patients treated at an oncology service in the private health sector in Belo Horizonte.

Methods: Observational, retrospective, and cross-sectional study, based on the review of electronic medical records. The eligibility criteria included patients over 18 years old with a diagnosis of any cancer and staging, receiving a PD-1 inhibitor from January 2017 to January 2020.

Results: The sample consisted of 134 patients with lung cancer (46,3%), melanoma (34,3%), and kidney cancer (19,4%). The most common adverse event (AE) related to treatment were fatigue (51.5%), anorexia (23.1%), hypothyroidism (15.7%), and skin rash (14.9%), being grades 1 and 2 more prevalent. Between 3 and 12 months, there were more cutaneous, nutritional, and metabolic toxicities, and fatigue was present throughout the entire treatment period. Gastrointestinal and pulmonary toxicities were more frequent up to the 9th month.

Conclusion: Based on real-world evidence, it was possible to reveal important findings to support the safe practice of PD-1 inhibitors treatment. Fatigue was the most prevalent AE among patients. In addition, the kinetics of AE allowed the identification of major occurrences according to the period o treatment, allowing more precise monitoring and surveillance.

Keywords: Antineoplastic antibodies; Drugs - related side effects and adverse reactions related; Immunotherapy.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Brazil / epidemiology
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Renal Cell* / drug therapy
  • Cross-Sectional Studies
  • Fatigue / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Kidney Neoplasms* / drug therapy
  • Lung Neoplasms* / drug therapy
  • Melanoma* / drug therapy
  • Retrospective Studies

Substances

  • Immune Checkpoint Inhibitors