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Nice L, Bycroft R, Wu X, et al. Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors. J Oncol Pharm Pract. 2020;27(7):1736-1742doi: 10.1177/1078155220968909.
Nice, L., Bycroft, R., Wu, X., Rai, S. N., Figg, L., Bhandari, S., & Burd, M. (2021). Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors. Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 27(7), 1736-1742. https://doi.org/10.1177/1078155220968909
Nice, Laura, et al. "Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors." Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners vol. 27,7 (2021): 1736-1742. doi: https://doi.org/10.1177/1078155220968909
Nice L, Bycroft R, Wu X, Rai SN, Figg L, Bhandari S, Burd M. Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors. J Oncol Pharm Pract. 2021 Oct;27(7):1736-1742. doi: 10.1177/1078155220968909. Epub 2020 Oct 25. PMID: 33100180.
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J Oncol Pharm Pract. 2021 Oct;27(7):1736-1742. doi: 10.1177/1078155220968909. Epub 2020 Oct 25.

Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

Laura Nice, Ryan Bycroft, Xiaoyong Wu, Shesh N Rai, Lindsay Figg, Shruti Bhandari, Megan Burd

Affiliations

  1. Department of Pharmacy, University of Louisville Hospital, Louisville, KY, USA.
  2. Biostatistics and Bioinformatics Facility, University of Louisville James Graham Brown Cancer Center, Louisville, KY, USA.
  3. Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA.
  4. Department of Hematology and Medical Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY, USA.

PMID: 33100180 DOI: 10.1177/1078155220968909

Abstract

INTRODUCTION: Immune checkpoint inhibitors (ICIs) have become the standard of care in many cancer types. As the number of patients receiving ICIs for various cancers continues to expand, patients and practitioners should be aware of potentially severe immune-related adverse events (irAEs). Despite reports of the incidence of grade 3/4 toxicities, the proportion of patients whose symptoms were clinically severe enough to warrant hospitalization for adverse event management is unknown.

METHODS: This single center, retrospective, observational study was designed to determine the impact of irAEs on patients and the hospital. Patients who started ICIs from May 2016 through May 2019 for melanoma or lung cancer were included. The primary outcome was incidence of hospitalization for irAE. Secondary outcomes included median length of hospitalization, time to onset of irAE, rates of hospitalization for irAE per each checkpoint inhibitor regimen, organ system affected, progression free survival, and overall survival.

RESULTS: Of 384 patients with melanoma or lung cancer, 27 (7%) were hospitalized at our institution for an irAE. The most common irAE leading to hospitalization was colitis for patients with melanoma and pneumonitis for patients with lung cancer. The median length of stay across all hospitalizations was 10 days. Twenty-five patients required the use of corticosteroids while hospitalized, while eight of these patients required second line irAE treatment. For the total patient population, 34.7% experienced a grade 1/2 irAE and 13.1% experienced a grade 3/4 irAE.

CONCLUSION: Our cohort of patients experienced similar rates irAEs as reported in clinical trials and published reports.

Keywords: Immune-related adverse events; hospitalization; immune checkpoint inhibitors; immunotherapy; irAE

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