publication date: Sep. 11, 2020

A study published in the Journal of the National Comprehensive Cancer Network adds important knowledge about how immunotherapy-related adverse events can impact more than one organ in a single patient.

This study provides new information on how frequently multiple organ side effects occur, and reveals that multi-organ irAEs are more likely to happen sequentially rather than simultaneously.

Multi-organ irAEs are under-recognized, under-reported, and their pathophysiology is poorly understood, lead researcher Ganessan Kichenadasse, of Flinders Centre for Innovation in Cancer, Flinders University, Australia, said in a statement. We need a concerted international effort to improve our understanding and help identify predisposing factors and prevention strategies. Treating teams should be aware of the potential for irAEs which affect multiple organs and institute plans for recognizing and managing them.

The researchers evaluated the incidence and patterns of multi-organ irAEs using individual patient data from four non-small cell lung cancer trials where patients were treated with atezolizumab, a PD-L1 inhibitor. Those four studies, known as OAK, POPLAR, BIRCH, and FIR, include investigators from around the world. Out of 1,548 patients worldwide, 27% experienced at least one adverse event; 5.4% experienced multi-organ irAEs. Skin, laboratory, endocrine, neurologic and pulmonary abnormalities represented the most common organ systems involved.

Among the 84 cases with multi-organ irAEs, 70 patients (83.3%) had two organ systems affected, 13 (15.5%) had three, and one patient had four systems affected. 86% of multi-organ irAE patients experienced these side-effects sequentially rather than concurrently. According to the results, multi-organ irAEs were generally amenable to satisfactory management, and their occurrence was associated with better overall survival rates.

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JNCCN study sheds light on multi-organ adverse events from immunotherapy - The Cancer Letter

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