A multicenter characterization of hepatitis associated with immune checkpoint inhibitors
| العنوان: | A multicenter characterization of hepatitis associated with immune checkpoint inhibitors |
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| المؤلفون: | Sarah E. Fenton, April K.S. Salama, Sunandana Chandra, Lucy Boyce Kennedy, Georgina V. Long, Akansha Chowdhary, Chanjuan Shi, Daniella E Portal, J. Randall Patrinely, Sara N. Horst, Marisa Palmeri, Janice M. Mehnert, Alexander M. Menzies, Douglas B. Johnson, Meghan J. Mooradian, Jeffrey A. Sosman, Elizabeth A. Scoville, Ryan J. Sullivan, Ben McGuigan |
| المصدر: | Oncoimmunology article-version (VoR) Version of Record OncoImmunology, Vol 10, Iss 1 (2021) |
| بيانات النشر: | Taylor & Francis, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, Male, medicine.medical_specialty, Nausea, medicine.medical_treatment, Immunology, Gastroenterology, Asymptomatic, survival, Hepatitis, immune checkpoint inhibitors, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Immunology and Allergy, Humans, Adverse effect, Melanoma, RC254-282, Original Research, Retrospective Studies, business.industry, Infant, Newborn, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, toxicity, Retrospective cohort study, Immunosuppression, RC581-607, medicine.disease, Discontinuation, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Cohort, immune-related adverse events, Immunologic diseases. Allergy, medicine.symptom, Neoplasm Recurrence, Local, business, Research Article |
| الوصف: | Immune checkpoint inhibitors (ICI) predispose patients to immune-related adverse events (irAEs). Although hepatitis is a potentially lethal toxicity, the timing and outcomes have not been well described. In this retrospective study, patients from six international institutions were included if they were treated with ICIs and developed immune-related hepatitis. Patient and tumor characteristics, and hepatitis management and outcomes were evaluated. Of the 164 patients included, most were male (53.7%) with a median age of 63.0 years. Most patients had melanoma (83.5%) and stage IV disease (86.0%). Median follow-up was 585 days; median OS and PFS were not reached. The initial grade of hepatitis was most often grade 2 (30.5%) or 3 (45.7%) with a median time to onset of 61 days. Patients were most commonly asymptomatic (46.2%), but flu-like symptoms, including fatigue/anorexia (17.1%), nausea/emesis (14.0%), abdominal/back pain (11.6%), and arthralgias/myalgias (8.5%) occurred. Most patients received glucocorticoids (92.1%); the median time to improvement by one grade was 13.0 days, and the median time to complete resolution was 52.0 days. Second-line immunosuppression was required in 37 patients (22.6%), and steroid-dose re-escalation in 45 patients (27.4%). Five patients (3%) died of ICI-hepatitis or complications of hepatitis treatment. Ninety-one patients (58.6%) did not resume ICI; of 66 patients (40 grade 1/2, 26 grade 3/4) that were rechallenged, only 25.8% (n = 17) had recurrence. In this multi-institutional cohort, immune-related hepatitis was associated with excellent outcomes but frequently required therapy discontinuation, high-dose steroids, and second-line immunosuppression. Rechallenge was associated with a modest rate of hepatitis recurrence. |
| اللغة: | English |
| تدمد: | 2162-402X 2162-4011 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::350c1b9732fb1b97f8808aae068cbfc4 http://europepmc.org/articles/PMC7889227 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....350c1b9732fb1b97f8808aae068cbfc4 |
| قاعدة البيانات: | OpenAIRE |
PDF full text from Publisher | تدمد: | 2162402X 21624011 |
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