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| 001 | 289667 | ||
| 005 | 20250819111806.0 | ||
| 024 | 7 | _ | |a 10.1016/j.ejca.2024.114028 |2 doi |
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| 024 | 7 | _ | |a (1990) |2 ISSN |
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| 041 | _ | _ | |a English |
| 082 | _ | _ | |a 610 |
| 100 | 1 | _ | |a Ruf, Theresa |b 0 |
| 245 | _ | _ | |a Second-line therapies for steroid-refractory immune-related adverse events in patients treated with immune checkpoint inhibitors. |
| 260 | _ | _ | |a Amsterdam [u.a.] |c 2024 |b Elsevier |
| 336 | 7 | _ | |a article |2 DRIVER |
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| 520 | _ | _ | |a Immune 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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| 650 | _ | 7 | |a Immune checkpoint inhibitors |2 Other |
| 650 | _ | 7 | |a Immune-related adverse events |2 Other |
| 650 | _ | 7 | |a Second-line immunosuppressants |2 Other |
| 650 | _ | 7 | |a Steroid-dependent |2 Other |
| 650 | _ | 7 | |a Steroid-refractory |2 Other |
| 700 | 1 | _ | |a Kramer, Rafaela |b 1 |
| 700 | 1 | _ | |a Forschner, Andrea |b 2 |
| 700 | 1 | _ | |a Leiter, Ulrike |b 3 |
| 700 | 1 | _ | |a Meier, Friedegund |b 4 |
| 700 | 1 | _ | |a Reinhardt, Lydia |b 5 |
| 700 | 1 | _ | |a Dücker, Pia |b 6 |
| 700 | 1 | _ | |a Ertl, Carolin |b 7 |
| 700 | 1 | _ | |a Tomsitz, Dirk |b 8 |
| 700 | 1 | _ | |a Tietze, Julia K |b 9 |
| 700 | 1 | _ | |a Gutzmer, Ralf |b 10 |
| 700 | 1 | _ | |a Dabrowski, Evelyn |b 11 |
| 700 | 1 | _ | |a Zimmer, Lisa |0 P:(DE-HGF)0 |b 12 |
| 700 | 1 | _ | |a Gesierich, Anja |b 13 |
| 700 | 1 | _ | |a Zierold, Sarah |b 14 |
| 700 | 1 | _ | |a French, Lars E |b 15 |
| 700 | 1 | _ | |a Eigentler, Thomas |b 16 |
| 700 | 1 | _ | |a Amaral, Teresa |b 17 |
| 700 | 1 | _ | |a Heinzerling, Lucie |b 18 |
| 773 | _ | _ | |a 10.1016/j.ejca.2024.114028 |g Vol. 203, p. 114028 - |0 PERI:(DE-600)1468190-0 |p 114028 |t European journal of cancer |v 203 |y 2024 |x 0014-2964 |
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