What Factors Predict Severe Reactions from Immunotherapy? - European Medical Journal

What Factors Predict Severe Reactions from Immunotherapy?

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PREDICTING which patients with cancer may be at risk of severe side effects from immunotherapy may be improved through the identification of specific risk factors, according to a new large-scale analysis.

The study was led by researchers at Massachusetts General Hospital, Boston, Massachusetts, USA, and analysed patient data from a national health insurance claims database, 2011–2019, for 14,378 patients who received immune checkpoint inhibitors for cancer. In that period, 3.5% of the patients required hospitalisation because of severe side effects from immune checkpoint inhibitors and required immunosuppression to counteract the effects of the therapy.

Immune checkpoint inhibitors strengthen immune responses to cancer cells and can be very effective in cancer treatment; however, the side effects of the therapies on other organs can be potentially life-threatening. Weighing the risk of the therapies can pose a challenge for both clinicians and patients. The study aimed to analyse commonalities across patients experiencing severe side effects, to help identify risk factors for reactions and aid clinicians in predicting higher risk of reactions in future patients.

Risk factors for severe treatment toxicities identified by the analysis included younger age, melanoma, kidney cancer, and treatment with multiple immune checkpoint inhibitors, rather than an immune checkpoint inhibitor monotherapy.

“This study provides the foundation for studying severe immunotherapy toxicities using a Big Data analytic framework, which will be necessary when understanding the impact of these life-saving medications across diverse populations,” highlighted co-senior author Yevgeniy R. Semenov, Department of Dermatology at Massachusetts General Hospital. “Also, it is the first step in developing robust clinical risk prediction models to identify patients at highest risk for the development of life-threatening treatment complications.”

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