Risk of irAEs in patients with autoimmune diseases treated by immune checkpoint inhibitors for stage III or IV melanoma: results from a matched case–control study - Collection du Centre Méditerranéen de Médecine Moléculaire Access content directly
Journal Articles Annals of the Rheumatic Diseases Year : 2022

Risk of irAEs in patients with autoimmune diseases treated by immune checkpoint inhibitors for stage III or IV melanoma: results from a matched case–control study

1 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
2 IMVA-HB - Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes
3 UNICANCER/CRCL - Centre de Recherche en Cancérologie de Lyon
4 Centre Léon Bérard [Lyon]
5 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
6 PCCEI - Pathogenesis and Control of Chronic and Emerging Infections
7 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
8 Service de Dermatologie (CHU de Dijon)
9 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
10 Service de Dermatologie [Nice]
11 C3M - Centre méditerranéen de médecine moléculaire
12 CHU Amiens-Picardie
13 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
14 Hôpital Ambroise Paré [AP-HP]
15 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
16 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
17 CRLCC - CRLCC Eugène Marquis
18 Hôpital Avicenne [AP-HP]
19 UP13 - Université Paris 13
20 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
21 Service de Dermatologie et Allergologie [CHRU Nancy]
22 Service de dermatologie, vénéreologie et cancérologie cutanée [Hôpital de la Timone - APHM]
23 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
24 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier
25 Service de Dermatologie [AP-HP Hôpital Saint-Louis]
26 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
27 AP-HP - Hopital Saint-Louis [AP-HP]
28 Hôpital Hôtel-Dieu [Paris]
29 CHU Bordeaux
30 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
Sophie Dalac
Jean Philippe Arnault
Thierry Lesimple
Eve Maubec
Caroline Dutriaux
  • Function : Author
  • PersonId : 1101731

Abstract

Objective To quantify the risk of immune-related adverse events (irAEs) in patients with pre-existing autoimmune disease (pAID) treated by immune checkpoint inhibitors (ICIs) for stage III or IV melanoma. Methods Case–control study performed on a French multicentric prospective cohort of patients with melanoma, matched for irAE risk factors and oncological staging. Risk of irAE was assessed by logistic regression. Results 110 patients with pAID were included and matched with 330 controls, from March 2013 to October 2020. Over a median follow-up period of 7.2 months for cases and 6.9 months for controls, the ORs of developing all-grade and grade ≥3 irAEs among cases compared with controls were 1.91 (95% CI (1.56 to 2.27)) and 1.44 (95% CI (1.08 to 1.82)), respectively. Patients with pAID had an increased risk of multiple irAEs (OR 1.46, 95% CI (1.15 to 2.67)) and a shorter time to irAE onset. In contrast, there were no difference in irAE-related mortality nor in the rate of treatment discontinuation, and a landmark analysis revealed a better survival at 24 months among cases (p=0.02). Thirty per cent of cases experienced a pAID flare during follow-up, and baseline immunosuppression did not prevent irAE occurrence. Last, we report associations between the pAID clinical subsets and organ-specific irAEs. Conclusion In our study, patients with pAID were at greater risk of all-grade, severe and multiple irAEs, yet had a better 24-month survival than controls. Thus, patients with pAID should be eligible for ICI therapy but benefit from a close monitoring for irAE occurrence, especially during the first months of therapy.
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licence : CC BY NC - Attribution - NonCommercial

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hal-04079755 , version 1 (19-02-2024)

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Attribution - NonCommercial

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Léo Plaçais, Stéphane Dalle, Olivier Dereure, Sabiha Trabelsi, Sophie Dalac, et al.. Risk of irAEs in patients with autoimmune diseases treated by immune checkpoint inhibitors for stage III or IV melanoma: results from a matched case–control study. Annals of the Rheumatic Diseases, 2022, 81 (10), pp.1445-1452. ⟨10.1136/ard-2022-222186⟩. ⟨hal-04079755⟩
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