Incidence and outcomes of immune-related adverse events after immune checkpoint inhibitors in patients with Hodgkin lymphoma.

Abstract

e19513 Background: Immune checkpoint inhibitors (ICIs) have recently been found to be effective in Hodgkin lymphoma (HL). However, given the impaired systemic immune response in HL, it is unclear whether immune-related adverse events (irAEs) would manifest differently in this population; data on this topic remains scarce. Methods: Data were collected from an aggregated electronic medical record (EMR) database TriNetX Research Network (TriNetX LLC., Cambridge, Massachusetts, USA). Adult patients diagnosed with HL who received pembrolizumab or nivolumab between 1/2018 and 1/2022 were included. irAEs were identified through a set of validated ICD-10-CM codes. Results: Within the study period, a total of 567 patients with HL were identified. Among them, 363 (63.8%) patients received nivolumab and 263 (46.4%) received pembrolizumab. The mean age was 50.1 (SD 19.6) years-old, 227 (40.0%) patients were female, 69 (12.2%) were black, and 156 (27.5%) received ICI-based therapy as the frontline treatment. irAE of any grade occurred in 280 (49.4%) of patients. Patients who experienced irAEs were more likely to be older (p = 0.0106), while using ICIs as the frontline or after various previous treatments was not associated with irAEs (Table). Among specific irAEs, skin toxicities, thyroid dysfunction, pneumonitis, colitis, and hepatitis occurred in 31.6%, 23.6%, 2.8%, 9.3%, and 3.2% of patients, respectively. Regarding the management for irAEs, systemic steroids, topical steroids, mycophenolate, and infliximab were used in 63.6%, 36.8%, 3.6%, and 3.6% of patients, respectively. Of note, ICIs were able to be resumed in 71.1% of patients with irAEs. After propensity-score matching for known prognostic factors for HL, patients with or without irAE had similar overall survival (OS) (hazard ratio 0.84, 95% confidence interval 0.57 to 1.23, p=0.36). No significant difference of OS was seen across different subtypes of irAE, including skin toxicities (p=0.64), thyroid dysfunction (p=0.74), or colitis (p=0.28). Conclusions: irAEs were common in patients with HL receiving ICIs. The majority of patients with irAEs were able to resume ICIs, and the development of irAEs did not affect overall survival. [Table: see text]