King's College London

Research portal

The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort.

Research output: Contribution to journalMeeting abstractpeer-review

Standard

The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort. / Olsson-Brown, Anna; Baxter, Mark; Feeney, Laura et al.

In: Journal of Clinical Oncology, Vol. 40, No. 16_suppl, 08.06.2022, p. 2522.

Research output: Contribution to journalMeeting abstractpeer-review

Harvard

Olsson-Brown, A, Baxter, M, Feeney, L, Tivey, A, Rodgers, L, Mughal, S, Lee, R, Gault, A, Dobeson, C, Rowe, M, Hughes, D, Heseltine, J, Parikh, S, Cotton, J, Salawu, A, Tinsley, N, Shotton, R, Angelakas, A, Zhao, S, Jones, C & UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH) 2022, 'The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort.', Journal of Clinical Oncology, vol. 40, no. 16_suppl, pp. 2522. https://doi.org/10.1200/JCO.2022.40.16_suppl.2522

APA

Olsson-Brown, A., Baxter, M., Feeney, L., Tivey, A., Rodgers, L., Mughal, S., Lee, R., Gault, A., Dobeson, C., Rowe, M., Hughes, D., Heseltine, J., Parikh, S., Cotton, J., Salawu, A., Tinsley, N., Shotton, R., Angelakas, A., Zhao, S., ... UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH) (2022). The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort. Journal of Clinical Oncology, 40(16_suppl), 2522. https://doi.org/10.1200/JCO.2022.40.16_suppl.2522

Vancouver

Olsson-Brown A, Baxter M, Feeney L, Tivey A, Rodgers L, Mughal S et al. The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort. Journal of Clinical Oncology. 2022 Jun 8;40(16_suppl):2522. https://doi.org/10.1200/JCO.2022.40.16_suppl.2522

Author

Olsson-Brown, Anna ; Baxter, Mark ; Feeney, Laura et al. / The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort. In: Journal of Clinical Oncology. 2022 ; Vol. 40, No. 16_suppl. pp. 2522.

Bibtex Download

@article{a21c39ec113c4bd88e82c9cbf5b8c6cb,
title = "The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort.",
abstract = "Background: Pre-existing autoimmune disease (AID) potentially increases the propensity for the development of immune related adverse events (irAE) in response to oncological immune checkpoint inhibitors (ICIs) is biologically plausible and clinically observed. However, due to consistent clinical trial exclusion of those with pre-existing AID, the impact on the frequency and severity of irAEs is uncertain. Here we analyse this relationship in a large, real-world, UK multi-centre cohort. Methods: A retrospective analysis of 2049 patients treated with ICIs over a two year period was undertaken across 12 National Health Service centres by the UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH). Patients received ICIs as standard of care for malignant melanoma, non-small cell lung cancer and renal cell carcinoma. The presence of pre-existing AIDs was assessed and classified as either autoantibody driven or autoinflammatory then correlated with clinically significant irAEs (i.e.≥grade2 or all-grade endocrinopathies). Statistical analyses included T-test, Mann-Whitney and Chi-squared. For overall survival(OS) Kaplan-Meier and log-rank tests were utilised.Results: Pre-existing AID were present in 13% (n = 257) of the overall cohort. Pre-existing endocrinopathies (30%; n = 76) were most common followed by rheumatological AIDs (18%; n = 46). In the pre-existing AID cohort there was a female predominance (48% vs 39%; p = 0.006) but no difference in smoking history (p =0.074) or ethnicity(p = 0.12). There was no difference in ICI treatment between those with and with-out pre-existing AID (p = 0.2800). IrAEs occurred in 45% (n = 117) patients with pre-existing AID vs 33% (n = 583) without (p£0.001). The median time to onset of irAEs was similar. IrAEs with an increased incidence in the pre-existing AID cohort were colitis (p = < 0.001), arthralgia (p = 0.008) and dermatological irAEs (p = 0.014). There was no difference in the incidence of irAEs in patients with autoantibody driven vs autoinflammatory pre-existing AID (44.0% vs 44.8%,p = 0.905). In the overall cohort, those with pre-existing AIDs had a median OS of 20.4months (95%CI:19.4-21.7) vs 14.1months (95%CI:12.8-16.3) in those without pre-existing AID (p = 0.004).Conclusions: This large multi-centre ICI-treated cohort demonstrates that pre-existing AID is a predisposing factor for the development of irAEs, however the incidence is lower than previously quoted. The pathological basis of pre-existing AID did not differentially affect irAE manifestation. Patients with pre-existing AID had improved OS compared to those without which has not been observed in previously reported studies. ICI treatment should be considered in those with pre-existing AID but further studies are needed to determine how best to optimise outcomes whilst mitigating the impact of irAEs.",
author = "Anna Olsson-Brown and Mark Baxter and Laura Feeney and Ann Tivey and Lisa Rodgers and Sohail Mughal and Rebecca Lee and Abigail Gault and Caroline Dobeson and Michael Rowe and Daniel Hughes and Jonathan Heseltine and Shefali Parikh and Jenny Cotton and Abdulazeez Salawu and Nadina Tinsley and Rohan Shotton and Angelos Angelakas and Steven Zhao and Christopher Jones and {UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH)}",
year = "2022",
month = jun,
day = "8",
doi = "10.1200/JCO.2022.40.16_suppl.2522",
language = "English",
volume = "40",
pages = "2522",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "16_suppl",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - The association of pre-existing autoimmune disease and immune-related adverse events secondary to immune checkpoint inhibition therapy in a UK multicenter cohort.

AU - Olsson-Brown, Anna

AU - Baxter, Mark

AU - Feeney, Laura

AU - Tivey, Ann

AU - Rodgers, Lisa

AU - Mughal, Sohail

AU - Lee, Rebecca

AU - Gault, Abigail

AU - Dobeson, Caroline

AU - Rowe, Michael

AU - Hughes, Daniel

AU - Heseltine, Jonathan

AU - Parikh, Shefali

AU - Cotton, Jenny

AU - Salawu, Abdulazeez

AU - Tinsley, Nadina

AU - Shotton, Rohan

AU - Angelakas, Angelos

AU - Zhao, Steven

AU - Jones, Christopher

AU - UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH), null

PY - 2022/6/8

Y1 - 2022/6/8

N2 - Background: Pre-existing autoimmune disease (AID) potentially increases the propensity for the development of immune related adverse events (irAE) in response to oncological immune checkpoint inhibitors (ICIs) is biologically plausible and clinically observed. However, due to consistent clinical trial exclusion of those with pre-existing AID, the impact on the frequency and severity of irAEs is uncertain. Here we analyse this relationship in a large, real-world, UK multi-centre cohort. Methods: A retrospective analysis of 2049 patients treated with ICIs over a two year period was undertaken across 12 National Health Service centres by the UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH). Patients received ICIs as standard of care for malignant melanoma, non-small cell lung cancer and renal cell carcinoma. The presence of pre-existing AIDs was assessed and classified as either autoantibody driven or autoinflammatory then correlated with clinically significant irAEs (i.e.≥grade2 or all-grade endocrinopathies). Statistical analyses included T-test, Mann-Whitney and Chi-squared. For overall survival(OS) Kaplan-Meier and log-rank tests were utilised.Results: Pre-existing AID were present in 13% (n = 257) of the overall cohort. Pre-existing endocrinopathies (30%; n = 76) were most common followed by rheumatological AIDs (18%; n = 46). In the pre-existing AID cohort there was a female predominance (48% vs 39%; p = 0.006) but no difference in smoking history (p =0.074) or ethnicity(p = 0.12). There was no difference in ICI treatment between those with and with-out pre-existing AID (p = 0.2800). IrAEs occurred in 45% (n = 117) patients with pre-existing AID vs 33% (n = 583) without (p£0.001). The median time to onset of irAEs was similar. IrAEs with an increased incidence in the pre-existing AID cohort were colitis (p = < 0.001), arthralgia (p = 0.008) and dermatological irAEs (p = 0.014). There was no difference in the incidence of irAEs in patients with autoantibody driven vs autoinflammatory pre-existing AID (44.0% vs 44.8%,p = 0.905). In the overall cohort, those with pre-existing AIDs had a median OS of 20.4months (95%CI:19.4-21.7) vs 14.1months (95%CI:12.8-16.3) in those without pre-existing AID (p = 0.004).Conclusions: This large multi-centre ICI-treated cohort demonstrates that pre-existing AID is a predisposing factor for the development of irAEs, however the incidence is lower than previously quoted. The pathological basis of pre-existing AID did not differentially affect irAE manifestation. Patients with pre-existing AID had improved OS compared to those without which has not been observed in previously reported studies. ICI treatment should be considered in those with pre-existing AID but further studies are needed to determine how best to optimise outcomes whilst mitigating the impact of irAEs.

AB - Background: Pre-existing autoimmune disease (AID) potentially increases the propensity for the development of immune related adverse events (irAE) in response to oncological immune checkpoint inhibitors (ICIs) is biologically plausible and clinically observed. However, due to consistent clinical trial exclusion of those with pre-existing AID, the impact on the frequency and severity of irAEs is uncertain. Here we analyse this relationship in a large, real-world, UK multi-centre cohort. Methods: A retrospective analysis of 2049 patients treated with ICIs over a two year period was undertaken across 12 National Health Service centres by the UK National Oncology Trainees Collaborative for Healthcare Research (NOTCH). Patients received ICIs as standard of care for malignant melanoma, non-small cell lung cancer and renal cell carcinoma. The presence of pre-existing AIDs was assessed and classified as either autoantibody driven or autoinflammatory then correlated with clinically significant irAEs (i.e.≥grade2 or all-grade endocrinopathies). Statistical analyses included T-test, Mann-Whitney and Chi-squared. For overall survival(OS) Kaplan-Meier and log-rank tests were utilised.Results: Pre-existing AID were present in 13% (n = 257) of the overall cohort. Pre-existing endocrinopathies (30%; n = 76) were most common followed by rheumatological AIDs (18%; n = 46). In the pre-existing AID cohort there was a female predominance (48% vs 39%; p = 0.006) but no difference in smoking history (p =0.074) or ethnicity(p = 0.12). There was no difference in ICI treatment between those with and with-out pre-existing AID (p = 0.2800). IrAEs occurred in 45% (n = 117) patients with pre-existing AID vs 33% (n = 583) without (p£0.001). The median time to onset of irAEs was similar. IrAEs with an increased incidence in the pre-existing AID cohort were colitis (p = < 0.001), arthralgia (p = 0.008) and dermatological irAEs (p = 0.014). There was no difference in the incidence of irAEs in patients with autoantibody driven vs autoinflammatory pre-existing AID (44.0% vs 44.8%,p = 0.905). In the overall cohort, those with pre-existing AIDs had a median OS of 20.4months (95%CI:19.4-21.7) vs 14.1months (95%CI:12.8-16.3) in those without pre-existing AID (p = 0.004).Conclusions: This large multi-centre ICI-treated cohort demonstrates that pre-existing AID is a predisposing factor for the development of irAEs, however the incidence is lower than previously quoted. The pathological basis of pre-existing AID did not differentially affect irAE manifestation. Patients with pre-existing AID had improved OS compared to those without which has not been observed in previously reported studies. ICI treatment should be considered in those with pre-existing AID but further studies are needed to determine how best to optimise outcomes whilst mitigating the impact of irAEs.

U2 - 10.1200/JCO.2022.40.16_suppl.2522

DO - 10.1200/JCO.2022.40.16_suppl.2522

M3 - Meeting abstract

VL - 40

SP - 2522

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 16_suppl

ER -

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454