Background: Immune checkpoint inhibitors (ICIs) have become common lines of therapy for genitourinary cancers (GUcs). Given their widespread use, understanding the risk factors, comparative profiles, and timing of immune-related adverse events (irAEs) is essential. Methods: We created an IRB-approved retrospective registry of all patients who received at least one dose of an ICI for any indication between 1 February 2011 and 7 April 2022 at a comprehensive cancer center and its outreach clinics. Dichotomous outcomes were modeled using multivariable logistic regression. Survival outcomes were compared using multivariable Cox regression. Results: Among 3101 patients, 196 had renal cell carcinoma (RCC) and 170 had urothelial tumors. RCC patients were more likely to experience irAEs (OR 1.78; 95% CI 1.32–2.39), whereas urothelial carcinoma patients were not (OR 1.22; 95% CI 0.88–1.67). RCC patients were more prone to dermatitis, thyroiditis, acute kidney injury, and myocarditis, compared to other tumors, while urothelial carcinoma patients were not. The impact of irAEs on survival was not significantly different for GUcs compared to other tumors. Conclusions: RCC primaries have a significantly different irAE profile than most tumors, as opposed to urothelial primaries. Further, RCC was more likely to experience any irAEs. Heterogeneity of survival benefits by irAEs was not seen.
背景：免疫检查点抑制剂已成为泌尿生殖系统肿瘤的常规治疗方案。鉴于其广泛应用，了解免疫相关不良事件的风险因素、比较特征及发生时机至关重要。方法：我们建立了一项经机构审查委员会批准的回顾性登记研究，纳入2011年2月1日至2022年4月7日期间在某综合癌症中心及其附属诊所接受至少一剂免疫检查点抑制剂治疗的所有适应症患者。采用多变量逻辑回归模型分析二分类结局，使用多变量Cox回归比较生存结局。结果：在3101例患者中，196例为肾细胞癌，170例为尿路上皮肿瘤。肾细胞癌患者发生免疫相关不良事件的风险更高（比值比1.78；95%置信区间1.32-2.39），而尿路上皮癌患者则无此趋势（比值比1.22；95%置信区间0.88-1.67）。与其他肿瘤类型相比，肾细胞癌患者更易出现皮炎、甲状腺炎、急性肾损伤和心肌炎，而尿路上皮癌患者未见此特征。免疫相关不良事件对泌尿生殖系统肿瘤患者生存期的影响与其他肿瘤类型无显著差异。结论：与其他肿瘤类型相比，肾细胞癌原发肿瘤的免疫相关不良事件特征存在显著差异，而尿路上皮癌原发肿瘤则无此差异。此外，肾细胞癌患者发生任何免疫相关不良事件的可能性更高。未发现免疫相关不良事件对生存获益存在异质性影响。
Immune-Related Adverse Events of Genitourinary Cancer Patients, a Retrospective Cohort Study
肿瘤(癌症)患者之家