Document resource
Background and Importance Immune checkpoint inhibitor (ICI) therapy can cause toxicities known as immune-related adverse events (irAEs), which are similar to autoimmune diseases because they arise from the immune system attacking healthy tissues.Aim and Objectives To describe and analyse the incidence of irAEs in patients receiving treatment with ICIs.Material and Methods A retrospective, descriptive and, observational study was performed in cancer patients with ICIs (nivolumab, pembrolizumab, ipilimumab, cemiplimab, durvalumab, atezolizumab, and avelumab). Inclusion criteria: Patients who had received at least two cycles with a PCI between February 2024 and February 2025. Variables collected were: age, sex, treatment discontinuation and reason, irAEs experienced, severity (according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0), and management (treatment delay or discontinuation).Results Seventy-two patients (65.3% men) were included, median age of 69 years (37–88). A 47.2% of patients experienced an irAE, excluding elevated liver enzymes and mild, transient hyperglycemia (grade 1). IrAEs were observed in 40% of patients receiving atezolizumab, 55.5% receiving nivolumab, 47.1% receiving pembrolizumab, 50% receiving durvalumab, 25% receiving cemiplimab, 66.7% receiving avelumab, and 60% receiving the ipilimumab and nivolumab. A 61.5% of irAEs were grade 2 (31.9% of patients) and 9.6% were grade 3 (5.5%). No grade 4 or 5 irAEs were recorded. A 3.8% of irAEs required admission to an inpatient unit, 9.6% treatment delay and 17.3% discontinuation. A 13.9% of patients experienced elevated liver enzymes (one developed hepatitis). Fifteen patients presented hyperglycemia (five developed diabetes). A 20.8% presented an altered thyroid profile, (12.5% hypothyroidism and 12.5% hyperthyroidism). Ten patients presented some immune-mediated skin reaction. Four patients presented colitis and all had to discontinue treatment. Two patients presented grade 2 renal toxicity (one discontinue treatment). Three patients presented arthritis (one discontinue treatment). Two patients presented myositis (one required a delay and other permanent discontinuation). Other irAEs observed were: grade-2 adrenal insufficiency, pancreatitis requiring treatment discontinuation, gastritis requiring hospitalisation, hypoparathyroidism, grade-2 ocular xerosis, and peripheral polyneuropathy.Conclusion and Relevance Our experience reveals a new spectrum of toxicities associated with ICIs that are different from those of conventional chemotherapy. However, toxicity is not the main reason for discontinuation. IrAEs complexity requires numerous specialists to detect and manage them correctly.Conflict of Interest No conflict of interest