Cutaneous immune-related AEs predict longer survival in cancer patients on ICI

Developing cutaneous immune-related adverse events (cirAEs) among advanced cancer patients on immune checkpoint inhibitor (ICI) appears to be a sign of longer overall survival, particularly in those with melanoma, suggests a recent study.

“CirAEs occur in up to 40 percent of ICI recipients. However, the association of cirAEs with survival remains unclear,” the investigators said.

To address this knowledge gap, the investigators identified a total of 3,731 ICI recipients from the Mass General Brigham healthcare system and Dana-Farber Cancer Institute and reviewed patient charts for cirAE development within 2 years after ICI initiation.

They also examined the impact of cirAEs on survival using multivariate time-varying Cox proportional hazards models, adjusted for age, sex, race/ethnicity, Charlson Comorbidity Index, ICI type, cancer type, and year of ICI initiation.

Of the recipients, 18.1 developed cirAE. In 6-month landmark analysis and time-varying Cox proportional hazards models, patients with cirAEs had reduced mortality (hazard ratio [HR], 0.87; p=0.027), especially those with melanoma (HR, 0.67; p=0.003).

Specifically, the following AEs significantly correlated with improved survival after multiple comparisons adjustment: lichenoid eruption (HR, 0.51; p<0.001), psoriasiform eruption (HR, 0.52; p=0.005), vitiligo (HR, 0.29; p=0.007), isolated pruritus without visible manifestation of rash (HR, 0.71; p=0.007), acneiform eruption (HR, 0.34; p=0.025), and nonspecific rash (HR, 0.68; p<0.001).

This study was limited by its retrospective design and single geography, according to the investigators.