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Abstract Number: 361

Risk Factors of Immune-Related Adverse Events in Patients Treated with Anti-Programmed Cell Death 1 Antibody Pembrolizumab

In Young Kim1, Yeonghee Eun1, Hyungjin Kim1, Joong Kyong Ahn2, Eun-Jung Park3, Chan Hong Jeon4, Jinseok Kim5, Hoon-Suk Cha1, Eun-Mi Koh1 and Jaejoon Lee1, 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South), 2Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South), 3Department of Medicine, National Medical Center, Seoul, Korea, Republic of (South), 4Department of Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea, Republic of (South), 5Department of Medicine, Jeju National University Hospital, University of Jeju School of Medicine, Jeju, Korea, Republic of (South)

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: adverse events and cancer treatments, Immunotherapy, PD-1

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Session Information

Date: Sunday, October 21, 2018

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I: Checkpoint Inhibitors, Retroperitoneal Fibrosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Immune checkpoint inhibitors have been established as a novel standard treatment for various types of malignancies. However, these new class of drugs have led to increased immune-related adverse events (irAEs) including rheumatic manifestations.
The aim of this study was to determine the risk factors of irAEs in patients treated with anti-programmed death 1 antibody pembrolizumab.

Methods: A retrospective medical record review was performed to identify all patients who received at least one dose of pembrolizumab at Samsung Medical Center, Seoul, Korea between June 2015 and December 2017. Three hundred and ninety-one patients were identified. Multivariate logistic regression model was used to identify risk factors of irAEs.

Results: The median number of cycles of pembrolizumab was two (range, 1-36). The primary malignancies included in the study were lung cancer (n=211, 54.0%), melanoma (n=74, 18.9%), lymphoma (n=53, 13.6%) and others (n=53, 13.6%). Sixty-seven (17.1%) patients experienced clinically significant irAEs; most commonly dermatologic disorders (n=39, 10.0%), pneumonitis (n=11, 2.8%), musculoskeletal disorders (n=10, 2.6%), followed by endocrine disorders (n=7, 1.8%). Fourteen patients (3.6%) experienced serious irAEs (≥ grade 3). Most common serious irAEs were pneumonitis (n=9, 2.3%). There were 4 deaths associated with irAEs, all of which were due to pneumonitis. In univariate logistic regression analysis, body mass index, number of cycles and cumulative dose of pembrolizumab, and baseline neutrophil-lymphocyte ratio were the risk factors of irAEs in pembrolizuamb-treated patients. Multivariate logistic regression analysis was performed with variables that were significant in univariate analysis. Higher body mass index and multiple cycles of pembrolizumab were associated with higher risk of irAEs (body mass index: odds ratio [OR] 1.080, 95% confidence interval [95% CI] 1.005-1.161, P = 0.035; pembrolizumab cycle: OR 1.153, 95% CI 1.087-1.224, P < 0.001). Low neutrophil-leukocyte ratio tended to increase irAE risk, but not statistically significant in multivariate analysis (OR 0.953, 95% CI 0.902-1.007, P = 0.089).

Conclusion: To our knowledge, this is the first study to explore the risk factor for irAE in patients undergoing modern cancer immunotherapy. Our study demonstrate that BMI is associated with an increased risk of irAEs in patients treated with pembrolizumab. Also, the number of cycles of pembrolizumab was a risk factor for the development of irAEs. Further studies to investigate the potential mechanisms by which obesity raises irAEs are needed.


Disclosure: I. Y. Kim, None; Y. Eun, None; H. Kim, None; J. K. Ahn, None; E. J. Park, None; C. H. Jeon, None; J. Kim, None; H. S. Cha, None; E. M. Koh, None; J. Lee, None.

To cite this abstract in AMA style:

Kim IY, Eun Y, Kim H, Ahn JK, Park EJ, Jeon CH, Kim J, Cha HS, Koh EM, Lee J. Risk Factors of Immune-Related Adverse Events in Patients Treated with Anti-Programmed Cell Death 1 Antibody Pembrolizumab [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/risk-factors-of-immune-related-adverse-events-in-patients-treated-with-anti-programmed-cell-death-1-antibody-pembrolizumab/. Accessed .
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