Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC
Background: Limited data are available on late immune-related adverse events (IRAEs) in patients with metastatic NSCLC receiving immunotherapy (ICI) beyond 2 years. Methods: A single-institution retrospective analysis including patients who received longer than 2 years of ICI therapy for metastatic...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | JTO Clinical and Research Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364325000682 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849253670101712896 |
|---|---|
| author | Omar Elghawy, MD Adam Barsouk, MD Jonathan H. Sussman, BS Benjamin A. Bleiberg, MD Lauren Reed-Guy, MD Christopher D’Avella, MD Aditi Singh, MD Christine Ciunci, MD, MSCE Kyle Robinson, MD John Kosteva, MD Corey Langer, MD Roger B. Cohen, MD Charu Aggarwal, MD, MPH Melina Marmarelis, MD, MSCE Lova Sun, MD, MSCE |
| author_facet | Omar Elghawy, MD Adam Barsouk, MD Jonathan H. Sussman, BS Benjamin A. Bleiberg, MD Lauren Reed-Guy, MD Christopher D’Avella, MD Aditi Singh, MD Christine Ciunci, MD, MSCE Kyle Robinson, MD John Kosteva, MD Corey Langer, MD Roger B. Cohen, MD Charu Aggarwal, MD, MPH Melina Marmarelis, MD, MSCE Lova Sun, MD, MSCE |
| author_sort | Omar Elghawy, MD |
| collection | DOAJ |
| description | Background: Limited data are available on late immune-related adverse events (IRAEs) in patients with metastatic NSCLC receiving immunotherapy (ICI) beyond 2 years. Methods: A single-institution retrospective analysis including patients who received longer than 2 years of ICI therapy for metastatic NSCLC between 2012 and 2023 was performed. Late IRAEs were defined as those occurring longer than 2 years after initiation of ICI therapy. The association of late IRAE with OS and PFS was assessed using an extended Cox regression with late IRAE modeled as a time-varying covariate. Results: In a cohort of 76 patients who received longer than 2 years of ICI, the median duration of treatment was 41.9 months, and 44 out of 76 (58%) experienced an early IRAE before 2 years. After 2 years on ICI, 38 out of 76 (50%) of patients experienced a late IRAE, many of whom (39%) had no previous early IRAE. Higher rates of late IRAEs were seen in females (p = 0.032), White patients (p = 0.041), and patients with previous grade 2 or higher IRAE (p = 0.020). Late IRAE occurrence was not associated with median progression-free survival or median overall survival. Conclusions: In patients receiving extended-duration ICI beyond 2 years, late IRAEs were common and often occurred in patients without previous history of IRAE. These findings support consideration of ICI discontinuation at 2 years. |
| format | Article |
| id | doaj-art-f87fae93de3c4ec9bbb710d0ba8d1a2a |
| institution | Kabale University |
| issn | 2666-3643 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj-art-f87fae93de3c4ec9bbb710d0ba8d1a2a2025-08-20T03:56:14ZengElsevierJTO Clinical and Research Reports2666-36432025-09-016910085110.1016/j.jtocrr.2025.100851Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLCOmar Elghawy, MD0Adam Barsouk, MD1Jonathan H. Sussman, BS2Benjamin A. Bleiberg, MD3Lauren Reed-Guy, MD4Christopher D’Avella, MD5Aditi Singh, MD6Christine Ciunci, MD, MSCE7Kyle Robinson, MD8John Kosteva, MD9Corey Langer, MD10Roger B. Cohen, MD11Charu Aggarwal, MD, MPH12Melina Marmarelis, MD, MSCE13Lova Sun, MD, MSCE14Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaCorresponding author. Address for correspondence: Lova Sun, MD, West Pavilion, 3400 Civic Center Blvd 2nd Floor, Philadelphia 19104, Pennsylvania.; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PennsylvaniaBackground: Limited data are available on late immune-related adverse events (IRAEs) in patients with metastatic NSCLC receiving immunotherapy (ICI) beyond 2 years. Methods: A single-institution retrospective analysis including patients who received longer than 2 years of ICI therapy for metastatic NSCLC between 2012 and 2023 was performed. Late IRAEs were defined as those occurring longer than 2 years after initiation of ICI therapy. The association of late IRAE with OS and PFS was assessed using an extended Cox regression with late IRAE modeled as a time-varying covariate. Results: In a cohort of 76 patients who received longer than 2 years of ICI, the median duration of treatment was 41.9 months, and 44 out of 76 (58%) experienced an early IRAE before 2 years. After 2 years on ICI, 38 out of 76 (50%) of patients experienced a late IRAE, many of whom (39%) had no previous early IRAE. Higher rates of late IRAEs were seen in females (p = 0.032), White patients (p = 0.041), and patients with previous grade 2 or higher IRAE (p = 0.020). Late IRAE occurrence was not associated with median progression-free survival or median overall survival. Conclusions: In patients receiving extended-duration ICI beyond 2 years, late IRAEs were common and often occurred in patients without previous history of IRAE. These findings support consideration of ICI discontinuation at 2 years.http://www.sciencedirect.com/science/article/pii/S2666364325000682ImmunotherapyNon–small cell lung cancerImmune-related adverse eventsDrug toxicityOverall survival |
| spellingShingle | Omar Elghawy, MD Adam Barsouk, MD Jonathan H. Sussman, BS Benjamin A. Bleiberg, MD Lauren Reed-Guy, MD Christopher D’Avella, MD Aditi Singh, MD Christine Ciunci, MD, MSCE Kyle Robinson, MD John Kosteva, MD Corey Langer, MD Roger B. Cohen, MD Charu Aggarwal, MD, MPH Melina Marmarelis, MD, MSCE Lova Sun, MD, MSCE Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC JTO Clinical and Research Reports Immunotherapy Non–small cell lung cancer Immune-related adverse events Drug toxicity Overall survival |
| title | Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC |
| title_full | Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC |
| title_fullStr | Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC |
| title_full_unstemmed | Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC |
| title_short | Late Immune-Related Adverse Events After At Least Two Years of Immune Checkpoint Inhibitor Therapy: Incidence and Association With Survival in Patients With Advanced NSCLC |
| title_sort | late immune related adverse events after at least two years of immune checkpoint inhibitor therapy incidence and association with survival in patients with advanced nsclc |
| topic | Immunotherapy Non–small cell lung cancer Immune-related adverse events Drug toxicity Overall survival |
| url | http://www.sciencedirect.com/science/article/pii/S2666364325000682 |
| work_keys_str_mv | AT omarelghawymd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT adambarsoukmd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT jonathanhsussmanbs lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT benjaminableibergmd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT laurenreedguymd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT christopherdavellamd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT aditisinghmd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT christineciuncimdmsce lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT kylerobinsonmd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT johnkostevamd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT coreylangermd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT rogerbcohenmd lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT charuaggarwalmdmph lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT melinamarmarelismdmsce lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc AT lovasunmdmsce lateimmunerelatedadverseeventsafteratleasttwoyearsofimmunecheckpointinhibitortherapyincidenceandassociationwithsurvivalinpatientswithadvancednsclc |