Immune‐related adverse events predict responses to PD‐1 blockade immunotherapy in hepatocellular carcinoma

Immune checkpoint blockade has demonstrated remarkable efficacy in hepatocellular carcinoma (HCC) but is also commonly accompanied by immune‐related adverse events (irAEs). However, the association between irAEs and antitumor efficacy in HCC patients remains unknown. All patients with HCC treated wi...

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Veröffentlicht in:International journal of cancer 2021-08, Vol.149 (4), p.959-966
Hauptverfasser: Lu, Lianghe, Xing, Kaili, Wei, Wei, Ling, Yihong, Li, Peng, Li, Shaohua, Wang, Yan, Xie, Dan, Guo, Rongping, Cai, Muyan
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container_end_page 966
container_issue 4
container_start_page 959
container_title International journal of cancer
container_volume 149
creator Lu, Lianghe
Xing, Kaili
Wei, Wei
Ling, Yihong
Li, Peng
Li, Shaohua
Wang, Yan
Xie, Dan
Guo, Rongping
Cai, Muyan
description Immune checkpoint blockade has demonstrated remarkable efficacy in hepatocellular carcinoma (HCC) but is also commonly accompanied by immune‐related adverse events (irAEs). However, the association between irAEs and antitumor efficacy in HCC patients remains unknown. All patients with HCC treated with anti‐PD‐1 antibodies from July 2018 to November 2019 were analyzed and divided into different groups according to their irAEs' status. In total, 101 HCC patients, including 21 (20.8%) patients who presented with irAEs (irAEs+), were enrolled. Among the adverse events, rash (n = 9, 8.9%) was the most frequent irAE, followed by mucositis (n = 3, 3.0%) and thyroiditis (n = 3, 3.0%). Patients in the irAEs+ group showed a higher tumor response rate than those in the irAEs− group (overall response rate: 28.6% vs 6.3%, P = .011; disease control rate: 85.7% vs 60.0%, P = .028). The median progression‐free survival (PFS) times were 14.8 months in the irAEs+ group and 4.1 months in the irAEs− group (P 
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However, the association between irAEs and antitumor efficacy in HCC patients remains unknown. All patients with HCC treated with anti‐PD‐1 antibodies from July 2018 to November 2019 were analyzed and divided into different groups according to their irAEs' status. In total, 101 HCC patients, including 21 (20.8%) patients who presented with irAEs (irAEs+), were enrolled. Among the adverse events, rash (n = 9, 8.9%) was the most frequent irAE, followed by mucositis (n = 3, 3.0%) and thyroiditis (n = 3, 3.0%). Patients in the irAEs+ group showed a higher tumor response rate than those in the irAEs− group (overall response rate: 28.6% vs 6.3%, P = .011; disease control rate: 85.7% vs 60.0%, P = .028). The median progression‐free survival (PFS) times were 14.8 months in the irAEs+ group and 4.1 months in the irAEs− group (P &lt; .001). Further analysis based on the presence or absence of rash showed that the PFS of the patients in the irAEs+/rash+ group was better than that of those in the irAEs+/rash− or irAEs− group (all P &lt; .05). Multivariate analysis showed that irAEs were an independent prognostic factor for PFS (hazard ratio [HR]: 0.22, P = .002). Thus, the occurrence of irAEs, especially rash, was associated with markedly improved PFS. Awareness of irAEs may help classify the subtype of HCC patients with an unprecedented survival benefit from anti‐PD‐1 antibodies. What's new? While anti‐program death receptor‐1 (anti‐PD‐1) antibodies produce clinical responses in patients with hepatocellular carcinoma (HCC), variations in efficacy and in the occurrence of adverse events present significant challenges in the clinical management of HCC. In the present study, the authors show that in HCC patients treated with anti‐PD‐1 antibodies, the development of immune‐related adverse events (irAEs), notably rash, is associated with improved progression‐free survival. The marked association between irAEs and treatment response suggests that irAEs could be used to predict survival in anti‐PD‐1 antibody‐treated HCC patients and could facilitate HCC subtype classification in patients who experience striking survival benefits.</description><identifier>ISSN: 0020-7136</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.33609</identifier><identifier>PMID: 33890283</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Antibodies ; Antitumor activity ; anti‐PD‐1 antibodies ; Cancer ; Disease control ; Exanthema ; Hepatocellular carcinoma ; Immune checkpoint ; immune‐related adverse events ; Immunotherapy ; Liver cancer ; Medical research ; Mucositis ; Multivariate analysis ; prognosis ; Response rates ; Survival ; Thyroiditis ; tumor response</subject><ispartof>International journal of cancer, 2021-08, Vol.149 (4), p.959-966</ispartof><rights>2021 UICC.</rights><rights>2021 UICC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4549-6fbbb96fae677dd471dd1404e1a400f156abca9f7c8b64dfe83df000689413783</citedby><cites>FETCH-LOGICAL-c4549-6fbbb96fae677dd471dd1404e1a400f156abca9f7c8b64dfe83df000689413783</cites><orcidid>0000-0003-2799-3463 ; 0000-0002-2860-6093</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijc.33609$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijc.33609$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33890283$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lu, Lianghe</creatorcontrib><creatorcontrib>Xing, Kaili</creatorcontrib><creatorcontrib>Wei, Wei</creatorcontrib><creatorcontrib>Ling, Yihong</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Li, Shaohua</creatorcontrib><creatorcontrib>Wang, Yan</creatorcontrib><creatorcontrib>Xie, Dan</creatorcontrib><creatorcontrib>Guo, Rongping</creatorcontrib><creatorcontrib>Cai, Muyan</creatorcontrib><title>Immune‐related adverse events predict responses to PD‐1 blockade immunotherapy in hepatocellular carcinoma</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>Immune checkpoint blockade has demonstrated remarkable efficacy in hepatocellular carcinoma (HCC) but is also commonly accompanied by immune‐related adverse events (irAEs). However, the association between irAEs and antitumor efficacy in HCC patients remains unknown. All patients with HCC treated with anti‐PD‐1 antibodies from July 2018 to November 2019 were analyzed and divided into different groups according to their irAEs' status. In total, 101 HCC patients, including 21 (20.8%) patients who presented with irAEs (irAEs+), were enrolled. Among the adverse events, rash (n = 9, 8.9%) was the most frequent irAE, followed by mucositis (n = 3, 3.0%) and thyroiditis (n = 3, 3.0%). Patients in the irAEs+ group showed a higher tumor response rate than those in the irAEs− group (overall response rate: 28.6% vs 6.3%, P = .011; disease control rate: 85.7% vs 60.0%, P = .028). The median progression‐free survival (PFS) times were 14.8 months in the irAEs+ group and 4.1 months in the irAEs− group (P &lt; .001). Further analysis based on the presence or absence of rash showed that the PFS of the patients in the irAEs+/rash+ group was better than that of those in the irAEs+/rash− or irAEs− group (all P &lt; .05). Multivariate analysis showed that irAEs were an independent prognostic factor for PFS (hazard ratio [HR]: 0.22, P = .002). Thus, the occurrence of irAEs, especially rash, was associated with markedly improved PFS. Awareness of irAEs may help classify the subtype of HCC patients with an unprecedented survival benefit from anti‐PD‐1 antibodies. What's new? While anti‐program death receptor‐1 (anti‐PD‐1) antibodies produce clinical responses in patients with hepatocellular carcinoma (HCC), variations in efficacy and in the occurrence of adverse events present significant challenges in the clinical management of HCC. In the present study, the authors show that in HCC patients treated with anti‐PD‐1 antibodies, the development of immune‐related adverse events (irAEs), notably rash, is associated with improved progression‐free survival. The marked association between irAEs and treatment response suggests that irAEs could be used to predict survival in anti‐PD‐1 antibody‐treated HCC patients and could facilitate HCC subtype classification in patients who experience striking survival benefits.</description><subject>Antibodies</subject><subject>Antitumor activity</subject><subject>anti‐PD‐1 antibodies</subject><subject>Cancer</subject><subject>Disease control</subject><subject>Exanthema</subject><subject>Hepatocellular carcinoma</subject><subject>Immune checkpoint</subject><subject>immune‐related adverse events</subject><subject>Immunotherapy</subject><subject>Liver cancer</subject><subject>Medical research</subject><subject>Mucositis</subject><subject>Multivariate analysis</subject><subject>prognosis</subject><subject>Response rates</subject><subject>Survival</subject><subject>Thyroiditis</subject><subject>tumor response</subject><issn>0020-7136</issn><issn>1097-0215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kb9u2zAQh4kiQe2kHfICBYEsySD7KFKiNBbOPwcG2qGdBYo8wXIkUSUlB97yCH3GPkno2O1QINMN992HH-5HyAWDGQOI5_VGzzhPIf9ApgxyGUHMkhMyDTuIJOPphJx5vwFgLAHxkUw4z3KIMz4l3bJtxw7_vPx22KgBDVVmi84jxS12g6e9Q1PrgTr0ve08ejpY-v0mHDBaNlY_KYO03kvssEan-h2tO7rGXg1WY9OMjXJUK6frzrbqEzmtVOPx83Gek593tz8WD9Hq2_1y8XUVaZGIPEqrsizztFKYSmmMkMwYJkAgUwKgYkmqSq3ySuqsTIWpMOOmAoA0ywXjMuPn5Org7Z39NaIfirb2-ziqQzv6Ik5YFseSiySgl_-hGzu6LqQLlOAyvFXyQF0fKO2s9w6rond1q9yuYFDsSyhCCcVbCYH9cjSOZYvmH_n36wGYH4DnusHd-6Zi-bg4KF8B5vSTjA</recordid><startdate>20210815</startdate><enddate>20210815</enddate><creator>Lu, Lianghe</creator><creator>Xing, Kaili</creator><creator>Wei, Wei</creator><creator>Ling, Yihong</creator><creator>Li, Peng</creator><creator>Li, Shaohua</creator><creator>Wang, Yan</creator><creator>Xie, Dan</creator><creator>Guo, Rongping</creator><creator>Cai, Muyan</creator><general>John Wiley &amp; Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2799-3463</orcidid><orcidid>https://orcid.org/0000-0002-2860-6093</orcidid></search><sort><creationdate>20210815</creationdate><title>Immune‐related adverse events predict responses to PD‐1 blockade immunotherapy in hepatocellular carcinoma</title><author>Lu, Lianghe ; Xing, Kaili ; Wei, Wei ; Ling, Yihong ; Li, Peng ; Li, Shaohua ; Wang, Yan ; Xie, Dan ; Guo, Rongping ; Cai, Muyan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4549-6fbbb96fae677dd471dd1404e1a400f156abca9f7c8b64dfe83df000689413783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibodies</topic><topic>Antitumor activity</topic><topic>anti‐PD‐1 antibodies</topic><topic>Cancer</topic><topic>Disease control</topic><topic>Exanthema</topic><topic>Hepatocellular carcinoma</topic><topic>Immune checkpoint</topic><topic>immune‐related adverse events</topic><topic>Immunotherapy</topic><topic>Liver cancer</topic><topic>Medical research</topic><topic>Mucositis</topic><topic>Multivariate analysis</topic><topic>prognosis</topic><topic>Response rates</topic><topic>Survival</topic><topic>Thyroiditis</topic><topic>tumor response</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lu, Lianghe</creatorcontrib><creatorcontrib>Xing, Kaili</creatorcontrib><creatorcontrib>Wei, Wei</creatorcontrib><creatorcontrib>Ling, Yihong</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Li, Shaohua</creatorcontrib><creatorcontrib>Wang, Yan</creatorcontrib><creatorcontrib>Xie, Dan</creatorcontrib><creatorcontrib>Guo, Rongping</creatorcontrib><creatorcontrib>Cai, Muyan</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, Lianghe</au><au>Xing, Kaili</au><au>Wei, Wei</au><au>Ling, Yihong</au><au>Li, Peng</au><au>Li, Shaohua</au><au>Wang, Yan</au><au>Xie, Dan</au><au>Guo, Rongping</au><au>Cai, Muyan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immune‐related adverse events predict responses to PD‐1 blockade immunotherapy in hepatocellular carcinoma</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2021-08-15</date><risdate>2021</risdate><volume>149</volume><issue>4</issue><spage>959</spage><epage>966</epage><pages>959-966</pages><issn>0020-7136</issn><eissn>1097-0215</eissn><abstract>Immune checkpoint blockade has demonstrated remarkable efficacy in hepatocellular carcinoma (HCC) but is also commonly accompanied by immune‐related adverse events (irAEs). However, the association between irAEs and antitumor efficacy in HCC patients remains unknown. All patients with HCC treated with anti‐PD‐1 antibodies from July 2018 to November 2019 were analyzed and divided into different groups according to their irAEs' status. In total, 101 HCC patients, including 21 (20.8%) patients who presented with irAEs (irAEs+), were enrolled. Among the adverse events, rash (n = 9, 8.9%) was the most frequent irAE, followed by mucositis (n = 3, 3.0%) and thyroiditis (n = 3, 3.0%). Patients in the irAEs+ group showed a higher tumor response rate than those in the irAEs− group (overall response rate: 28.6% vs 6.3%, P = .011; disease control rate: 85.7% vs 60.0%, P = .028). The median progression‐free survival (PFS) times were 14.8 months in the irAEs+ group and 4.1 months in the irAEs− group (P &lt; .001). Further analysis based on the presence or absence of rash showed that the PFS of the patients in the irAEs+/rash+ group was better than that of those in the irAEs+/rash− or irAEs− group (all P &lt; .05). Multivariate analysis showed that irAEs were an independent prognostic factor for PFS (hazard ratio [HR]: 0.22, P = .002). Thus, the occurrence of irAEs, especially rash, was associated with markedly improved PFS. Awareness of irAEs may help classify the subtype of HCC patients with an unprecedented survival benefit from anti‐PD‐1 antibodies. What's new? While anti‐program death receptor‐1 (anti‐PD‐1) antibodies produce clinical responses in patients with hepatocellular carcinoma (HCC), variations in efficacy and in the occurrence of adverse events present significant challenges in the clinical management of HCC. In the present study, the authors show that in HCC patients treated with anti‐PD‐1 antibodies, the development of immune‐related adverse events (irAEs), notably rash, is associated with improved progression‐free survival. The marked association between irAEs and treatment response suggests that irAEs could be used to predict survival in anti‐PD‐1 antibody‐treated HCC patients and could facilitate HCC subtype classification in patients who experience striking survival benefits.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>33890283</pmid><doi>10.1002/ijc.33609</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2799-3463</orcidid><orcidid>https://orcid.org/0000-0002-2860-6093</orcidid><oa>free_for_read</oa></addata></record>
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subjects Antibodies
Antitumor activity
anti‐PD‐1 antibodies
Cancer
Disease control
Exanthema
Hepatocellular carcinoma
Immune checkpoint
immune‐related adverse events
Immunotherapy
Liver cancer
Medical research
Mucositis
Multivariate analysis
prognosis
Response rates
Survival
Thyroiditis
tumor response
title Immune‐related adverse events predict responses to PD‐1 blockade immunotherapy in hepatocellular carcinoma
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