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000289667 1001_ $$aRuf, Theresa$$b0
000289667 245__ $$aSecond-line therapies for steroid-refractory immune-related adverse events in patients treated with immune checkpoint inhibitors.
000289667 260__ $$aAmsterdam [u.a.]$$bElsevier$$c2024
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000289667 520__ $$aImmune checkpoint inhibitors (ICI) induce adverse events (irAEs) that do not respond to steroids, i.e. steroid-refractory (sr) irAEs, and irAEs in which steroids cannot be tapered, i.e. steroid-dependent (sd) irAEs, in about 10% of cases. An evidence-based analysis of the effectiveness of second-line immunosuppressive agents with regard to irAE and tumor control is lacking.The international web-based Side Effect Registry Immuno-Oncology (SERIO; http://serio-registry.org) is a collaborative initiative with the Paul-Ehrlich-Institute to document rare, severe, complex or therapy-refractory immunotherapy-induced side effects. The registry was queried on August 1, 2023 for cases of irAEs which were treated with second-line therapies.From a total of 1330 cases, 217 patients (16.3%) received 249 second-line therapies. A total of 19 different second-line therapies were employed, including TNF-alpha antagonists (46.5%), intravenous immunoglobulins (IVIG; 19.1%), mycophenolate mofetil (15.9%), and methotrexate (3.6%). Therapy choices were determined by the type of irAE. The time to onset of sr-/sd-irAEs after ICI initiation did not consistently differ from steroid-responsive irAEs. While 74.3% of sr-/sd-irAEs resolved and 13.1% had improved, 4.3% persisted, 3.9% resulted in permanent sequelae, and 4.3% in death with ongoing symptoms. Infliximab exhibited potential for earlier symptom improvement compared to mycophenolate mofetil or IVIG. Tumor response in patients with second-line treated sd-/sr-irAE was similar to patients with irAEs treated with steroids only.Several second-line therapies are effective against sr-/sd-irAEs, the second-line therapies show no clear negative impact on tumor response, and infliximab shows potential for faster improvement of symptoms. However, prospective comparative data are needed.
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000289667 650_7 $$2Other$$aImmune checkpoint inhibitors
000289667 650_7 $$2Other$$aImmune-related adverse events
000289667 650_7 $$2Other$$aSecond-line immunosuppressants
000289667 650_7 $$2Other$$aSteroid-dependent
000289667 650_7 $$2Other$$aSteroid-refractory
000289667 7001_ $$aKramer, Rafaela$$b1
000289667 7001_ $$aForschner, Andrea$$b2
000289667 7001_ $$aLeiter, Ulrike$$b3
000289667 7001_ $$aMeier, Friedegund$$b4
000289667 7001_ $$aReinhardt, Lydia$$b5
000289667 7001_ $$aDücker, Pia$$b6
000289667 7001_ $$aErtl, Carolin$$b7
000289667 7001_ $$aTomsitz, Dirk$$b8
000289667 7001_ $$aTietze, Julia K$$b9
000289667 7001_ $$aGutzmer, Ralf$$b10
000289667 7001_ $$aDabrowski, Evelyn$$b11
000289667 7001_ $$0P:(DE-HGF)0$$aZimmer, Lisa$$b12
000289667 7001_ $$aGesierich, Anja$$b13
000289667 7001_ $$aZierold, Sarah$$b14
000289667 7001_ $$aFrench, Lars E$$b15
000289667 7001_ $$aEigentler, Thomas$$b16
000289667 7001_ $$aAmaral, Teresa$$b17
000289667 7001_ $$aHeinzerling, Lucie$$b18
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