Steroid-Refractory Immune-Related Adverse Events Induced by Checkpoint Inhibitors

Tomsitz D, Ruf T, Zierold S, French LE, Heinzerling L (2023)

Publication Type: Journal article

Publication year: 2023


Book Volume: 15

Article Number: 2538

Journal Issue: 9

DOI: 10.3390/cancers15092538


The occurrence, second-line management and outcome of sr/sd-irAEs was investigated in patients with skin cancer. All skin cancer patients treated with immune checkpoint inhibitors (ICIs) between 2013 and 2021 at a tertiary care center were analyzed retrospectively. Adverse events were coded by CTCAE version 5.0. The course and frequency of irAEs were summarized using descriptive statistics. A total of 406 patients were included in the study. In 44.6% (n = 181) of patients, 229 irAEs were documented. Out of those, 146 irAEs (63.8%) were treated with systemic steroids. Sr-irAEs and sd-irAEs (n = 25) were detected in 10.9% of all irAEs, and in 6.2% of ICI-treated patients. In this cohort, infliximab (48%) and mycophenolate mofetil (28%) were most often administered as second-line immunosuppressants. The type of irAE was the most important factor associated with the choice of second-line immunosuppression. The Sd/sr-irAEs resolved in 60% of cases, had permanent sequelae in 28% of cases, and required third-line therapy in 12%. None of the irAEs were fatal. Although these side effects manifest in only 6.2% of patients under ICI therapy, they impose difficult therapy decisions, especially since there are few data to determine the optimal second-line immunosuppression.

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How to cite


Tomsitz, D., Ruf, T., Zierold, S., French, L.E., & Heinzerling, L. (2023). Steroid-Refractory Immune-Related Adverse Events Induced by Checkpoint Inhibitors. Cancers, 15(9).


Tomsitz, Dirk, et al. "Steroid-Refractory Immune-Related Adverse Events Induced by Checkpoint Inhibitors." Cancers 15.9 (2023).

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