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Adverse events during immunotherapy in Slovenian patients with metastatic melanoma reveal a positive correlation with better treatment outcomes

Tanja Mesti

Tanja Mesti

Department of Medical Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Mesti, Tanja
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Vid Ceplak Mencin

Vid Ceplak Mencin

Department of Medical Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Ceplak Mencin, Vid
, 
Biljana Mileva Boshkoska

Biljana Mileva Boshkoska

  • Faculty of information studies in Novo mestoNovo mesto, Slovenia
  • Department for Knowledge Technologies, Institute Jožef StefanLjubljana, Slovenia
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Mileva Boshkoska, Biljana
 and 
Janja Ocvirk

Janja Ocvirk

  • Department of Medical Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Ocvirk, Janja
  
May 04, 2021
Adverse events during immunotherapy in Slovenian patients with metastatic melanoma reveal a positive correlation with better treatment outcomes's Cover Image
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Article Category: Research Article
Published Online: May 04, 2021
Page range: 354 - 361
Received: Nov 24, 2020
Accepted: Mar 16, 2021
DOI: https://doi.org/10.2478/raon-2021-0019
Keywords
© 2021 Tanja Mesti, Vid Ceplak Mencin, Biljana Mileva Boshkoska, Janja Ocvirk, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Distribution of immune-related adverse events by type in the irAE cohort.irAE cohort = patients with metastatic melanoma who developed immune-related side effects during immunotherapy
Distribution of immune-related adverse events by type in the irAE cohort.irAE cohort = patients with metastatic melanoma who developed immune-related side effects during immunotherapy

Figure 2

Distribution of immune-related adverse events by grade (1-3) regarding the type of immune-related adverse event in the irAE cohort presented as a percentage (%).irAE cohort = patients with metastatic melanoma who developed immune-related side effects during immunotherapy
Distribution of immune-related adverse events by grade (1-3) regarding the type of immune-related adverse event in the irAE cohort presented as a percentage (%).irAE cohort = patients with metastatic melanoma who developed immune-related side effects during immunotherapy

Figure 3

Distribution of the treatment response between the irAE and NirAE. The numbers above the bars represent the percentages with respect to its cohort, while the bar height is the absolute number of patients and is given on the Y axis.irAE cohort = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy
Distribution of the treatment response between the irAE and NirAE. The numbers above the bars represent the percentages with respect to its cohort, while the bar height is the absolute number of patients and is given on the Y axis.irAE cohort = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy

Figure 4

Correlation between the treatment response and the grade (1-3) of the immune-related side effect adverse events in the irAE cohort presented as a percentage (%).CR = complete response; PD = partial response; PR = progression of disease; SD = stable disease
Correlation between the treatment response and the grade (1-3) of the immune-related side effect adverse events in the irAE cohort presented as a percentage (%).CR = complete response; PD = partial response; PR = progression of disease; SD = stable disease

Figure 5

CORRELATION between the treatment response and the type of immune-related adverse events in the irAE cohort presented as percentages (%).CR = complete response; PD = partial response; PR = progression of disease; SD = stable disease
CORRELATION between the treatment response and the type of immune-related adverse events in the irAE cohort presented as percentages (%).CR = complete response; PD = partial response; PR = progression of disease; SD = stable disease

Figure 6

Progression-free survival difference in patients with metastatic melanoma between the two cohorts, cohort with immune-related adverse events (irAEs) and cohort with no immune-related adverse events (NirAEs), presented in days. The orange line indicates the median, while the patients who belong to the fourth quartile are represented with plus signs (“+”).irAE cohort = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy
Progression-free survival difference in patients with metastatic melanoma between the two cohorts, cohort with immune-related adverse events (irAEs) and cohort with no immune-related adverse events (NirAEs), presented in days. The orange line indicates the median, while the patients who belong to the fourth quartile are represented with plus signs (“+”).irAE cohort = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy

Figure 7

Difference in progression-free survival between the irAE and NirAE cohorts, with a significant increase in the survival probability from less than 60% for the NirAE cohort to almost 80% for the irAE cohort.irAE cohort = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy
Difference in progression-free survival between the irAE and NirAE cohorts, with a significant increase in the survival probability from less than 60% for the NirAE cohort to almost 80% for the irAE cohort.irAE cohort = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy

Figure 8

Difference in progression-free survival between the irAE and NirAE cohorts with increased LDH, with a significant increase in the survival probability from less than 40% for the NirAE cohort to more than 60% for the irAE cohort.irAE cohor = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy
Difference in progression-free survival between the irAE and NirAE cohorts with increased LDH, with a significant increase in the survival probability from less than 40% for the NirAE cohort to more than 60% for the irAE cohort.irAE cohor = patients with metastatic melanoma who developed immune-related adverse events during immunotherapy; NirAE cohort = patients with metastatic melanoma who did not develop immune-related adverse events during immunotherapy

Figure 9

Difference in progression free survival between the irAE and NirAE cohort with M1a and M1b (M1a/b) patients, with a significant increase in the survival probability of approximately 50% for NirAE cohort to more than 80% for irAE cohort.irAE cohort = patients with metastatic melanoma that developed immune-related adverse events during immunotherapy; M1a/b = distant metastasis to skin, soft tissue including muscle and/or nonregional lymph node and lungs; NirAE cohort = patients with metastatic melanoma that did not develop immune-related adverse events during immunotherapy;
Difference in progression free survival between the irAE and NirAE cohort with M1a and M1b (M1a/b) patients, with a significant increase in the survival probability of approximately 50% for NirAE cohort to more than 80% for irAE cohort.irAE cohort = patients with metastatic melanoma that developed immune-related adverse events during immunotherapy; M1a/b = distant metastasis to skin, soft tissue including muscle and/or nonregional lymph node and lungs; NirAE cohort = patients with metastatic melanoma that did not develop immune-related adverse events during immunotherapy;

Figure 10

Difference in progression free survival between the irAE and NirAE cohort with M1c and M1d (M1c/d) patients, with a significant increase in the survival probability of almost 70% for NirAE cohort to less than 50% for irAE cohort.irAE cohort = patients with metastatic melanoma that developed immune-related adverse events during immunotherapy; M1c/d = distant metastasis to other visceral sites than lungs and to the central nervous system (CNS); NirAE cohort = patients with metastatic melanoma that did not develop immune-related adverse events during immunotherapy
Difference in progression free survival between the irAE and NirAE cohort with M1c and M1d (M1c/d) patients, with a significant increase in the survival probability of almost 70% for NirAE cohort to less than 50% for irAE cohort.irAE cohort = patients with metastatic melanoma that developed immune-related adverse events during immunotherapy; M1c/d = distant metastasis to other visceral sites than lungs and to the central nervous system (CNS); NirAE cohort = patients with metastatic melanoma that did not develop immune-related adverse events during immunotherapy

Baseline characteristics of the cohorts

Characteristics irAE cohort n (%) NirAE cohort n (%)
Number 38 (38) 61 (62)
Age mean 67.4 61.6
Sex Male 18 (47.4) 37 (60.7)
Female 20 (52.6) 24 (39.3)
Treatment Naive 34 (89.5) 51 (83.6)
Previously treated 4 (10.5) 10 (16.4)
Immunotherapy Pembrolizumab 34 (89.5) 52 (85.2)
Nivolumab 2 (5.3) 5 (8.2)
Nivolumab + ipilimumab 2 (5.3) 4 (6.6)
BRAF status BRAF mutated 10 (26.3) 17 (27.9)
BRAF wild type 21 (55.3) 27 (44.3)
Not reported 7 (18.4) 17 (27.9)
M1a/b Cohort a and b 22 (57.9) 35 (57.4)
M1c/d Cohort c and d 16 (42.1) 26 (42.6)
LDH increased 7 (18.4) 15 (24.6)
LDH normal 31 (81.6) 46 (75.4)
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