Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer
Abstract Immunotherapy with PD-1 or PD-L1 inhibitors has become an essential treatment strategy for a growing number of malignancies. These treatments have a risk for immune-related adverse events (IRAEs). Pooled analyses based on clinical trials show a favorable toxicity profile for treatment with...
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| Format: | Article |
| Language: | English |
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Springer
2024-11-01
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| Series: | Cancer Immunology, Immunotherapy |
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| Online Access: | https://doi.org/10.1007/s00262-024-03869-1 |
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| author | Cecilia Olsson Ladjevardi Marcus Skribek Anthoula Koliadi Viktoria Rydén Ali Inan El-Naggar Evangelos Digkas Antonios Valachis Gustav J. Ullenhag |
| author_facet | Cecilia Olsson Ladjevardi Marcus Skribek Anthoula Koliadi Viktoria Rydén Ali Inan El-Naggar Evangelos Digkas Antonios Valachis Gustav J. Ullenhag |
| author_sort | Cecilia Olsson Ladjevardi |
| collection | DOAJ |
| description | Abstract Immunotherapy with PD-1 or PD-L1 inhibitors has become an essential treatment strategy for a growing number of malignancies. These treatments have a risk for immune-related adverse events (IRAEs). Pooled analyses based on clinical trials show a favorable toxicity profile for treatment with PD-L1 compared to PD-1 inhibitors. This study aimed to investigate differences in IRAEs between patients with advanced solid malignances treated with PD-L1 and PD-1 inhibitors in a real-world setting. We conducted a retrospective cohort study at four Swedish Regions. Patients (n = 605) treated for advanced cancer with a PD-L1 or PD-1 inhibitor in monotherapy between June 2016 and August 2022 were included. Non-small cell lung cancer (NSCLC) was the most common malignant disease (n = 251; 41.5%), followed by malignant melanoma (n = 173; 28.6%), renal cell carcinoma (n = 71; 11.7%) and urothelial carcinoma (n = 35; 5.8%). Among patients receiving PD-L1 inhibitors, NSCLC (94.4%) was the predominant malignancy, whereas for those treated with PD-1 inhibitor, malignant melanoma constituted the most prevalent malignancy (34.5%). Discontinuation of treatment due to IRAEs overall and IRAEs grade ≥ 2 were significantly less common in patients treated with PD-L1 compared to PD-1 inhibitors [Odds Ratio (OR): 0.38 (95% Confidence Interval (CI) 0.16–0.88) and OR: 0.63 (95% CI 0.35–0.98) respectively]. Any grade IRAE, IRAE grade ≥ 3 and multiple IRAEs were numerically more frequent in patients treated with PD-1 inhibitors.In conclusion, our study of patients with advanced solid malignancies in a real-world setting supports the results from clinical trials demonstrating a favorable toxicity profile for PD-L1 inhibitors versus PD-1 inhibitors. |
| format | Article |
| id | doaj-art-a30d8ef8e7d8482cbc12471d3b218425 |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Springer |
| record_format | Article |
| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-a30d8ef8e7d8482cbc12471d3b2184252025-02-02T12:26:51ZengSpringerCancer Immunology, Immunotherapy1432-08512024-11-017411810.1007/s00262-024-03869-1Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancerCecilia Olsson Ladjevardi0Marcus Skribek1Anthoula Koliadi2Viktoria Rydén3Ali Inan El-Naggar4Evangelos Digkas5Antonios Valachis6Gustav J. Ullenhag7Department of Immunology, Genetics, and Pathology, Uppsala UniversityThoracic Oncology Center, Theme Cancer, Karolinska University HospitalDepartment of Immunology, Genetics, and Pathology, Uppsala UniversityDepartment of Immunology, Genetics, and Pathology, Uppsala UniversityDepartment of Oncology, Faculty of Medicine and Health, Örebro UniversityDepartment of Immunology, Genetics, and Pathology, Uppsala UniversityDepartment of Oncology, Faculty of Medicine and Health, Örebro UniversityDepartment of Immunology, Genetics, and Pathology, Uppsala UniversityAbstract Immunotherapy with PD-1 or PD-L1 inhibitors has become an essential treatment strategy for a growing number of malignancies. These treatments have a risk for immune-related adverse events (IRAEs). Pooled analyses based on clinical trials show a favorable toxicity profile for treatment with PD-L1 compared to PD-1 inhibitors. This study aimed to investigate differences in IRAEs between patients with advanced solid malignances treated with PD-L1 and PD-1 inhibitors in a real-world setting. We conducted a retrospective cohort study at four Swedish Regions. Patients (n = 605) treated for advanced cancer with a PD-L1 or PD-1 inhibitor in monotherapy between June 2016 and August 2022 were included. Non-small cell lung cancer (NSCLC) was the most common malignant disease (n = 251; 41.5%), followed by malignant melanoma (n = 173; 28.6%), renal cell carcinoma (n = 71; 11.7%) and urothelial carcinoma (n = 35; 5.8%). Among patients receiving PD-L1 inhibitors, NSCLC (94.4%) was the predominant malignancy, whereas for those treated with PD-1 inhibitor, malignant melanoma constituted the most prevalent malignancy (34.5%). Discontinuation of treatment due to IRAEs overall and IRAEs grade ≥ 2 were significantly less common in patients treated with PD-L1 compared to PD-1 inhibitors [Odds Ratio (OR): 0.38 (95% Confidence Interval (CI) 0.16–0.88) and OR: 0.63 (95% CI 0.35–0.98) respectively]. Any grade IRAE, IRAE grade ≥ 3 and multiple IRAEs were numerically more frequent in patients treated with PD-1 inhibitors.In conclusion, our study of patients with advanced solid malignancies in a real-world setting supports the results from clinical trials demonstrating a favorable toxicity profile for PD-L1 inhibitors versus PD-1 inhibitors.https://doi.org/10.1007/s00262-024-03869-1PD-1 inhibitorsPD-L1 inhibitorsImmune-related adverse eventsAdvanced cancerCohort study |
| spellingShingle | Cecilia Olsson Ladjevardi Marcus Skribek Anthoula Koliadi Viktoria Rydén Ali Inan El-Naggar Evangelos Digkas Antonios Valachis Gustav J. Ullenhag Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer Cancer Immunology, Immunotherapy PD-1 inhibitors PD-L1 inhibitors Immune-related adverse events Advanced cancer Cohort study |
| title | Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer |
| title_full | Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer |
| title_fullStr | Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer |
| title_full_unstemmed | Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer |
| title_short | Differences in immune-related toxicity between PD-1 and PD-L1 inhibitors: a retrospective cohort study in patients with advanced cancer |
| title_sort | differences in immune related toxicity between pd 1 and pd l1 inhibitors a retrospective cohort study in patients with advanced cancer |
| topic | PD-1 inhibitors PD-L1 inhibitors Immune-related adverse events Advanced cancer Cohort study |
| url | https://doi.org/10.1007/s00262-024-03869-1 |
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