Association of Blood Biochemical Indexes and Antibiotic Exposure With Severe Immune-related Adverse Events in Patients With Advanced Cancers Receiving PD-1 Inhibitors

• Main Authors: Chen, C. (Author), Han, C. (Author), He, X. (Author), Jiang, N. (Author), Kong, C. (Author), Li, L. (Author), Li, Y. (Author), Song, X. (Author), Wang, X. (Author), Xu, J. (Author), Yin, L. (Author), Zhao, L. (Author), Zhu, X. (Author), Zong, D. (Author)
• Format: Article
• Language: English
• Published: NLM (Medline) 2022
• Subjects: adverse event; Anti-Bacterial Agents; antiinfective agent; case control study; Case-Control Studies; human; Humans; Immune Checkpoint Inhibitors; neoplasm; Neoplasms; prognosis; Prognosis
• Online Access: View Fulltext in Publisher

 Some patients with cancer treated with programmed death 1 (PD-1) inhibitors experience immune-related severe adverse events (ir-SAEs), however, predictors are limited. The objective was to identify clinicopathologic features that may be associated with a higher ir-SAE risk. This was a nested case-control study. After screening a total of 832 PD-1 inhibitor-treated patients, we identified 42 ir-SAE cases. According to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, ir-SAEs were defined as grade ≥3 toxic effects associated with immunotherapy. A total of 126 controls were matched. The crude and adjusted risks of ir-SAEs were estimated by odds ratio (ORs) and 95% CIs using multivariate logistic regression models. Baseline neutrophil-to-lymphocyte ratio (NLR) [per SD increment-adjusted (aOR): 1.16], lactate dehydrogenase (LDH) ≥245 U/L (aOR: 2.39), and antibiotic exposure (aOR: 4.39) were associated with a higher risk of ir-SAEs. When NLR was categorized in 3 groups, significantly higher risks of ir-SAEs (aOR: 4.95) were found in participants in group 3 (>6) than in those in group 1 (<3). Furthermore, NLR (per SD increment-adjusted hazard ratio:1.08) were also significantly associated with shorter overall survival (OS). Baseline LDH ≥245 U/L and antibiotic exposure were no significant association with OS. In conclusion, ir-SAEs were associated between baseline NLR, LDH ≥245 U/L and antibiotic exposure. Lower NLR was correlated with longer OS for cancer. Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.