Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors

Abstract Patients with cancer treated with immune checkpoint inhibitors (ICIs) develop immune related adverse events (irAEs), however biomarkers are lacking. We hypothesized that clinicopathologic and laboratory factors would be associated with irAE risk and overall survival (OS) in this population....

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Despina Michailidou, Ali Raza Khaki, Maria Pia Morelli, Leonidas Diamantopoulos, Namrata Singh, Petros Grivas
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/105536e94092471ba7088f449d11ce6f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:105536e94092471ba7088f449d11ce6f
record_format	dspace
spelling	oai:doaj.org-article:105536e94092471ba7088f449d11ce6f2021-12-02T16:55:24ZAssociation of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors10.1038/s41598-021-88307-32045-2322https://doaj.org/article/105536e94092471ba7088f449d11ce6f2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88307-3https://doaj.org/toc/2045-2322Abstract Patients with cancer treated with immune checkpoint inhibitors (ICIs) develop immune related adverse events (irAEs), however biomarkers are lacking. We hypothesized that clinicopathologic and laboratory factors would be associated with irAE risk and overall survival (OS) in this population. In a retrospective study of patients treated with ICIs we collected clinicopathologic, laboratory, irAEs and outcomes data. The association between baseline blood biomarkers, clinicopathologic features and irAEs was assessed by logistic regression adjusting for age, sex, smoking, cancer type, performance status, concomitant other systemic therapy, history of autoimmune disease (AD), chronic infection and pre-existing systemic steroid use (regardless of dose). Optimal cutoff values of biomarkers were identified by recursive partitioning analysis. 470 patients were identified; 156 (33%) developed irAEs, which were associated with baseline absolute lymphocyte count > 2.6 k/ul (adjusted [a]OR: 4.30), absolute monocyte count > 0.29 k/ul (aOR: 2.34) and platelet count > 145 k/ul (aOR: 2.23), neutrophil to lymphocyte ratio (NLR) ≤ 5.3 (aOR: 2.07) and monocyte to lymphocyte ratio (MLR) ≤ 0.73 (aOR: 2.96), as well as platelet to lymphocyte ratio ≤ 534 (aOR: 5.05). Patients with pre-existing AD (aOR: 2.57), family history of AD (aOR: 5.98), and ICI combination (aOR: 2.00) had higher odds of irAEs. Baseline NLR ≤ 5.3 (aHR: 0.68), MLR ≤ 0.73 (aHR: 0.43), PLT > 145 (aHR: 0.48) and PLR ≤ 534 (aHR: 0.48) were associated with longer OS. irAEs were associated with autoimmune history, ICI combination and baseline laboratory measurements. Lower NLR, MLR and PLR may have favorable prognostic value. Our hypothesis-generating findings require validation in larger prospective studies.Despina MichailidouAli Raza KhakiMaria Pia MorelliLeonidas DiamantopoulosNamrata SinghPetros GrivasNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Despina Michailidou Ali Raza Khaki Maria Pia Morelli Leonidas Diamantopoulos Namrata Singh Petros Grivas Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
description	Abstract Patients with cancer treated with immune checkpoint inhibitors (ICIs) develop immune related adverse events (irAEs), however biomarkers are lacking. We hypothesized that clinicopathologic and laboratory factors would be associated with irAE risk and overall survival (OS) in this population. In a retrospective study of patients treated with ICIs we collected clinicopathologic, laboratory, irAEs and outcomes data. The association between baseline blood biomarkers, clinicopathologic features and irAEs was assessed by logistic regression adjusting for age, sex, smoking, cancer type, performance status, concomitant other systemic therapy, history of autoimmune disease (AD), chronic infection and pre-existing systemic steroid use (regardless of dose). Optimal cutoff values of biomarkers were identified by recursive partitioning analysis. 470 patients were identified; 156 (33%) developed irAEs, which were associated with baseline absolute lymphocyte count > 2.6 k/ul (adjusted [a]OR: 4.30), absolute monocyte count > 0.29 k/ul (aOR: 2.34) and platelet count > 145 k/ul (aOR: 2.23), neutrophil to lymphocyte ratio (NLR) ≤ 5.3 (aOR: 2.07) and monocyte to lymphocyte ratio (MLR) ≤ 0.73 (aOR: 2.96), as well as platelet to lymphocyte ratio ≤ 534 (aOR: 5.05). Patients with pre-existing AD (aOR: 2.57), family history of AD (aOR: 5.98), and ICI combination (aOR: 2.00) had higher odds of irAEs. Baseline NLR ≤ 5.3 (aHR: 0.68), MLR ≤ 0.73 (aHR: 0.43), PLT > 145 (aHR: 0.48) and PLR ≤ 534 (aHR: 0.48) were associated with longer OS. irAEs were associated with autoimmune history, ICI combination and baseline laboratory measurements. Lower NLR, MLR and PLR may have favorable prognostic value. Our hypothesis-generating findings require validation in larger prospective studies.
format	article
author	Despina Michailidou Ali Raza Khaki Maria Pia Morelli Leonidas Diamantopoulos Namrata Singh Petros Grivas
author_facet	Despina Michailidou Ali Raza Khaki Maria Pia Morelli Leonidas Diamantopoulos Namrata Singh Petros Grivas
author_sort	Despina Michailidou
title	Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
title_short	Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
title_full	Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
title_fullStr	Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
title_full_unstemmed	Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
title_sort	association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/105536e94092471ba7088f449d11ce6f
work_keys_str_mv	AT despinamichailidou associationofbloodbiomarkersandautoimmunitywithimmunerelatedadverseeventsinpatientswithcancertreatedwithimmunecheckpointinhibitors AT alirazakhaki associationofbloodbiomarkersandautoimmunitywithimmunerelatedadverseeventsinpatientswithcancertreatedwithimmunecheckpointinhibitors AT mariapiamorelli associationofbloodbiomarkersandautoimmunitywithimmunerelatedadverseeventsinpatientswithcancertreatedwithimmunecheckpointinhibitors AT leonidasdiamantopoulos associationofbloodbiomarkersandautoimmunitywithimmunerelatedadverseeventsinpatientswithcancertreatedwithimmunecheckpointinhibitors AT namratasingh associationofbloodbiomarkersandautoimmunitywithimmunerelatedadverseeventsinpatientswithcancertreatedwithimmunecheckpointinhibitors AT petrosgrivas associationofbloodbiomarkersandautoimmunitywithimmunerelatedadverseeventsinpatientswithcancertreatedwithimmunecheckpointinhibitors
_version_	1718382840736907264

Association of blood biomarkers and autoimmunity with immune related adverse events in patients with cancer treated with immune checkpoint inhibitors

Ejemplares similares