Are immune checkpoint inhibitors safe for cancer patients?

Immune checkpoint inhibitors (ICIs) for the treatment of solid and haematological malignancies are well tolerated and show a similar rate of immune-related adverse effects (iRAEs) relative to published data, according to the results of a recent study. Corticosteroids are commonly used to manage iRAEs.

In this population-based retrospective analysis, a group of researchers evaluated the safety profile and discontinuation rate of ICIs in cancer patients aged ≥18 years who received at least one dose of ICI.

The rate of permanent discontinuation of ICIs due to iRAEs was the primary endpoint. Secondary ones included the rate and type of specific organ iRAEs, interventions used to treat specific organ iRAEs, and discontinuation rate of ICIs due to disease progression.

Seventy-five patients with a median age of 60 years were recruited in this study. Of these, seven (9.33 percent) had permanently ceased ICI treatment due to iRAEs. Seven iRAEs were documented in the seven patients who permanently discontinued ICI use.

Steroids were the main agent used for eight patients, followed by levothyroxine for two patients, while one did not receive any medication. In addition, 32 patients (42.66 percent) discontinued treatment due to disease progression.

“The discovery of ICIs caused a paradigm shift in cancer treatment and led to a major improvement in clinical outcomes,” the researchers said. “However, they may induce inflammatory side effects … known as iRAE.”