1. Association of immune-related adverse events induced by nivolumab with a battery of autoantibodies
- Author
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Inés Pérez, Severina Domínguez, Cristina Sánchez, Alicia Narro, Laura Puntí, Mireia Martínez, Saioa Eguiluz, Pilar Anaut, Iñigo Les, and Alberto Herrera
- Subjects
Male ,Battery (electricity) ,autoantibodies ,animal diseases ,medicine.medical_treatment ,Immune checkpoint inhibitors ,Immunology ,chemical and pharmacologic phenomena ,030204 cardiovascular system & hematology ,immune checkpoint inhibitors ,03 medical and health sciences ,Antineoplastic Agents, Immunological ,0302 clinical medicine ,Immune system ,Immune-related adverse events ,Rheumatoid Factor ,Neoplasms ,medicine ,cancer ,Humans ,030212 general & internal medicine ,Adverse effect ,Retrospective Studies ,nivolumab ,business.industry ,Autoantibody ,Cancer ,General Medicine ,Immunotherapy ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,bacteria ,Female ,immunotherapy ,prognosis ,Nivolumab ,business ,Research Article - Abstract
Background The aim of this study was to assess the diagnostic performance of an autoantibody battery in patients receiving immune checkpoint inhibitors who experienced immune-related adverse events (irAEs). Methods We retrospectively analyzed several variables potentially related to irAEs, namely, demographic, clinical, and laboratory characteristics, including an autoantibody battery (antinuclear, anti-neutrophil cytoplasmic, anti-thyroid antibodies and rheumatoid factor). Results Sixty-nine patients (48 men; 61.8 ± 10.9 years at baseline) diagnosed with stage-4 solid-organ cancer and treated with nivolumab were followed up for 12 ± 10.3 months. Thirty-two irAEs were detected in 26 patients (37.5%). Adverse events occurred more commonly in women (62% vs. 27%, p = .006), and younger patients (irAEs: 58.1 ± 9.8, no irAEs: 64.1 ± 10.9 years, p = .024). Autoantibody battery results were available for 26 patients and were more frequently positive in patients with irAEs (87% vs. 30%, p = .009). The positive predictive value, negative predictive value, and diagnostic accuracy of the battery were 82.3%, 77.8%, and 80.8%, respectively. Among the 64 patients with an evaluable response, 23 (38.5%) experienced tumour progression, this being less frequent in patients with irAEs (19% vs. 48.5%, p = .03). Overall survival was higher in patients developing irAEs (HR = 1.88, p = .05). Conclusion Positivity in a readily available autoantibody battery may be associated with the occurrence of irAEs.KEY MESSAGESPositivity in an accessible and inexpensive autoantibody battery including antinuclear, anti-neutrophil cytoplasmic, anti-thyroid antibodies and rheumatoid factor may be associated with the occurrence of immune-related adverse events.Patients with cancer on immune checkpoint inhibitors experiencing immune-related adverse events showed a lower risk of progression and better overall survival than patients not experiencing this type of adverse effect.
- Published
- 2021