Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events

Objective: Distinguishing immune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs) from the AEs caused by chemotherapy, targeted therapy, or infection is highly difficult. This study offers new insights into evaluating the diagnosis, differential diagnostic, and prognostic...

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Autores principales:	Weihong Zhang, Yuan Meng, Lin Yang, Meng Shen, Li Zhou, Runmei Li, Yang Wang, Weijiao Du, Yanjuan Xiong, Ying Han, Xinwei Zhang, Liang Liu, Xiubao Ren
Formato:	article
Lenguaje:	EN
Publicado:	China Anti-Cancer Association 2021
Materias:	ferritin diagnosis prognosis iraes pd-1 chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1f35fc1f305e4dacbf38d508d4a1651f
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spelling	oai:doaj.org-article:1f35fc1f305e4dacbf38d508d4a1651f2021-11-30T11:27:44ZFerritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events2095-394110.20892/j.issn.2095-3941.2021.0037https://doaj.org/article/1f35fc1f305e4dacbf38d508d4a1651f2021-11-01T00:00:00Zhttp://www.cancerbiomed.org/index.php/cocr/article/view/1887https://doaj.org/toc/2095-3941Objective: Distinguishing immune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs) from the AEs caused by chemotherapy, targeted therapy, or infection is highly difficult. This study offers new insights into evaluating the diagnosis, differential diagnostic, and prognostic value of ferritin for irAEs induced by ICIs. Methods: From December 1, 2018, to April 1, 2019, we examined 318 patients with malignant tumors who received serum ferritin monitoring. The cohort comprised 231 patients treated with PD-1 inhibitor or combination with chemotherapy, and 87 patients treated with chemotherapy. Of the 231 patients, 90 had irAEs (irAE group), 70 had non-irAEs (non-irAE group), 67 had no AEs (no irAE-non irAE group), and 4 had unclassified AEs. In the 87 patients, 60 had AEs (AE group), and 27 had no AEs (no AE group). Statistical analyses were conducted with nonparametric Mann-Whitney tests. Results: At the onset of AEs in the irAE group, ferritin (normal range, 35–150 µg/L) rose to a median of 927 µg/L (range, 117–17,825 µg/L) from 86 µg/L at baseline (range, 29–421 µg/L) (P < 0.001). Ferritin levels at the onset of AEs in the irAE group were significantly higher than those in the non-irAE group (median, 81 µg/L; range, 32–478 µg/L) (P < 0.001) and the AE group (median, 103 µg/L; range, 23–712 µg/L) (P < 0.001). After treatment in the irAE group, ferritin continuously decreased to a normal range in recovered patients, showed no significant changes in stable patients, and continued to rise in patients who died. Conclusions: Ferritin can be used as a diagnostic, differential diagnostic, and prognostic marker for irAEs in patients treated with ICIs.Weihong ZhangYuan MengLin YangMeng ShenLi ZhouRunmei LiYang WangWeijiao DuYanjuan XiongYing HanXinwei ZhangLiang LiuXiubao RenChina Anti-Cancer Associationarticleferritindiagnosisprognosisiraespd-1chemotherapyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Biology & Medicine, Vol 18, Iss 4, Pp 1109-1117 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ferritin diagnosis prognosis iraes pd-1 chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	ferritin diagnosis prognosis iraes pd-1 chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Weihong Zhang Yuan Meng Lin Yang Meng Shen Li Zhou Runmei Li Yang Wang Weijiao Du Yanjuan Xiong Ying Han Xinwei Zhang Liang Liu Xiubao Ren Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
description	Objective: Distinguishing immune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs) from the AEs caused by chemotherapy, targeted therapy, or infection is highly difficult. This study offers new insights into evaluating the diagnosis, differential diagnostic, and prognostic value of ferritin for irAEs induced by ICIs. Methods: From December 1, 2018, to April 1, 2019, we examined 318 patients with malignant tumors who received serum ferritin monitoring. The cohort comprised 231 patients treated with PD-1 inhibitor or combination with chemotherapy, and 87 patients treated with chemotherapy. Of the 231 patients, 90 had irAEs (irAE group), 70 had non-irAEs (non-irAE group), 67 had no AEs (no irAE-non irAE group), and 4 had unclassified AEs. In the 87 patients, 60 had AEs (AE group), and 27 had no AEs (no AE group). Statistical analyses were conducted with nonparametric Mann-Whitney tests. Results: At the onset of AEs in the irAE group, ferritin (normal range, 35–150 µg/L) rose to a median of 927 µg/L (range, 117–17,825 µg/L) from 86 µg/L at baseline (range, 29–421 µg/L) (P < 0.001). Ferritin levels at the onset of AEs in the irAE group were significantly higher than those in the non-irAE group (median, 81 µg/L; range, 32–478 µg/L) (P < 0.001) and the AE group (median, 103 µg/L; range, 23–712 µg/L) (P < 0.001). After treatment in the irAE group, ferritin continuously decreased to a normal range in recovered patients, showed no significant changes in stable patients, and continued to rise in patients who died. Conclusions: Ferritin can be used as a diagnostic, differential diagnostic, and prognostic marker for irAEs in patients treated with ICIs.
format	article
author	Weihong Zhang Yuan Meng Lin Yang Meng Shen Li Zhou Runmei Li Yang Wang Weijiao Du Yanjuan Xiong Ying Han Xinwei Zhang Liang Liu Xiubao Ren
author_facet	Weihong Zhang Yuan Meng Lin Yang Meng Shen Li Zhou Runmei Li Yang Wang Weijiao Du Yanjuan Xiong Ying Han Xinwei Zhang Liang Liu Xiubao Ren
author_sort	Weihong Zhang
title	Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
title_short	Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
title_full	Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
title_fullStr	Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
title_full_unstemmed	Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
title_sort	ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events
publisher	China Anti-Cancer Association
publishDate	2021
url	https://doaj.org/article/1f35fc1f305e4dacbf38d508d4a1651f
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Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events

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