Higher Rates of Immune-Related Adverse Effects Found in Early Breast Cancer Patients Treated with ICIs
A recent multi-institutional study has uncovered higher rates of immune-related adverse effects (irAEs) in patients with early-stage breast cancer treated with immune checkpoint inhibitors (ICIs) than previously reported. The study, led by Dr. Alexis LeVee, chief hematology/oncology fellow at City of Hope, was presented at the 2024 San Antonio Breast Cancer Symposium (SABCS).
The research involved 423 real-world patients with stage I to III breast cancer who were treated with ICIs at one of four academic institutions between 2014 and 2024. An irAE was defined as a toxicity potentially or definitely related to ICIs or high-dose steroids, after ruling out other causative agents.
Key Findings:
- 72.6% of patients experienced any-grade irAEs.
- 18.9% experienced high-grade irAEs.
These rates are notably higher than those found in the phase 3 KEYNOTE-522 trial, which investigated the combination of pembrolizumab (Keytruda) and chemotherapy in previously untreated patients with stage II or III triple-negative breast cancer. Dr. LeVee suggests that the increased rates of irAEs in the multi-institutional study may be due to the inclusion of patients with comorbidities, who are typically excluded from clinical trials.
Risk Factors Identified:
- Patients older than 50 years.
- Patients with chronic kidney disease.
Dr. LeVee emphasizes the importance of identifying patients at higher risk of irAEs to make informed treatment choices, highlighting the need for careful consideration of comorbidities in treatment planning.