2176P - Rechallenge of immune checkpoint inhibitors after immune-related adverse events: A systematic review

Background

Immune check point inhibitors (ICI)-based therapies have been remarkably advancing and dramatically changing the treatment modalities of cancer. This review aimed to comprehensively examine and rechallenge immune-related adverse events (irAE) across the literature.

Methods

We searched for clinical studies regarding the use of ICI published in English up to December 2021 in PubMed, Embase, Cochrane and journal of clinical oncology (JCO). The search strategy was composed of the following terms: [(rechallenge) AND (immune OR immunotherapy OR "immune checkpoint inhibitor")] AND ("side effect” OR "adverse event” OR irAE). Data were extracted by three independent investigators and the disagreements amongst investigators were resolved by consensus.

Results

The average duration of administration of ICI before the occurrence of irAE was 5.8 months (range 0.5 – 9). Discontinuation rate of ICI was 4-36.4% after the occurrence of irAE. IrAE leading to discontinuation varied depending on the type of ICI. However, the most common side effect was colitis with diarrhea regardless of the type of ICI. After ICI rechallenge, second irAE was administered to 40.3-78% of patient, and 48% of patients presented the same type of irAE as the first irAE.

Conclusions

ICI rechallenge appears to be safe given the balance between the advantages of rechallenge and the risk of irAE recurrence maintained by close monitoring.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.