Incidence of adverse drug reactions in immune checkpoint inhibitors among cancer patients with cancer at a University Hospital
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Abstract
Introduction: Immune checkpoint inhibitors (ICIs) are improving efficacy and transforming cancer care. However, specific immune related adverse events (irAEs) develop during ICI therapy and are not well defined in Thailand. This study aimed to investigate incidence of irAEs among patients with cancer with ICIs therapy. Method: We performed a retrospective study concerning patients treated with ICIs at Maharaj-Nakorn Chiang Mai Hospital, from January 1, 2014 to October 31, 2020. Descriptive statistics were applied for reporting incidence of irAEs. STATA®, Version 16.1 (StataCrop LP, College Station, TX, USA) was used to manage data for and all statistical analysis. Result: We identify 40 patients with cancer with ICIs therapy. The majority of patients were male (55%) with mean age 63.6 ± 11.7 years old. Almost one half of the subjects had non-small cell lung cancer (42.75%) and 27.5% had hepatocellular carcinoma. The most common ICIs therapy was nivolumab (57.5%). Median time to follow-up after ICIs use was 56 days. Twenty-six patients (65%) reported irAEs and 12 patients were related to one or more irAEs. Most (60%) irAEs were grade 1-2. Hepatitis was the most common irAE (22.5%), follow by respiratory symptom such as cough (17.5%) and dyspnea (17.5%). Conclusion: This study demonstrated the incidence of irAEs among patients with cancer with ICIs therapy was 65%, while the most common irAEs included respiratory system (cough and dyspnea) and gastro-intestinal tract system especially hepaitis. Health care providers will need to educate and monitor cancer patients to prevent irAEs using ICIs therapy.
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