Breast (Edinburgh, Scotland) · 2026
Risk factors of immune-related adverse events in patients with early-stage breast cancer: Findings from a multi-institutional retrospective study.
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LeVee Alexis, Jacob Saya, Fisch Samantha, Face Carolyne, Chengappa Madhuri, Chaudhry Saliha, Baclig Nikita, Soliman Andrew, Ruel Nora, Wong Megan, Tsai Karen, Kang Irene, Kordic Austin, Huppert Laura, Quintal Laura, Melisko Michelle, Majure Melanie, Chien Jo, Lechner Melissa, Idossa Dame, Blaes Anne, McCann Kelly, Rugo Hope S, Mortimer Joanne
Аннотация
INTRODUCTION: Identifying risk factors and biomarkers of immune-related adverse events (irAE) in patients with early-stage breast cancer could help prevent and mitigate irAE and improve disease outcomes. This retrospective cohort study aims to identify predictive biomarkers of irAE in patients with early-stage breast cancer treated with ICI.
METHODS: Patients with early-stage breast cancer treated with ICI between 2014 and 2024 from four institutions were included. Demographics, baseline laboratory values, and ICI treatment information were collected. Chi-square and Wilcoxon rank-sum tests were used to compare patients with and without any-grade irAE and grade ≥3 irAE. Uni- and multivariate logistic regression was performed to determine factors predictive of grade ≥3 irAE.
RESULTS: Of the 423 patients included, 307 (72.6%) developed any-grade irAE and 81 (19.1%) developed grade ≥3 irAE. Hispanic ethnicity was associated with lower rates of any-grade and grade ≥3 irAE compared to non-Hispanic/unknown ethnicity (p < 0.0001 and p = 0.04, respectively). Patients with higher absolute eosinophil counts were more likely to have any-grade irAE (p = 0.0005). Grade ≥3 irAE were more common in non-smokers (p = 0.05) and those with chronic kidney disease (CKD; p = 0.001). Multivariate logistic regression demonstrated that older age (≥50y vs. <50y) [OR 1.70; 95% CI, 1.02-2.85; p = 0.04] and CKD (OR 4.97; 95% CI, 1.59-15.5; p = 0.006) were predictive of grade ≥3 irAE.
CONCLUSION: In patients with early-stage breast cancer treated with ICI, older age and the presence of CKD were risk factors of grade ≥3 irAE. Further studies to identify biomarkers of irAE are needed to prevent irAE and reduce the long-term complications.
METHODS: Patients with early-stage breast cancer treated with ICI between 2014 and 2024 from four institutions were included. Demographics, baseline laboratory values, and ICI treatment information were collected. Chi-square and Wilcoxon rank-sum tests were used to compare patients with and without any-grade irAE and grade ≥3 irAE. Uni- and multivariate logistic regression was performed to determine factors predictive of grade ≥3 irAE.
RESULTS: Of the 423 patients included, 307 (72.6%) developed any-grade irAE and 81 (19.1%) developed grade ≥3 irAE. Hispanic ethnicity was associated with lower rates of any-grade and grade ≥3 irAE compared to non-Hispanic/unknown ethnicity (p < 0.0001 and p = 0.04, respectively). Patients with higher absolute eosinophil counts were more likely to have any-grade irAE (p = 0.0005). Grade ≥3 irAE were more common in non-smokers (p = 0.05) and those with chronic kidney disease (CKD; p = 0.001). Multivariate logistic regression demonstrated that older age (≥50y vs. <50y) [OR 1.70; 95% CI, 1.02-2.85; p = 0.04] and CKD (OR 4.97; 95% CI, 1.59-15.5; p = 0.006) were predictive of grade ≥3 irAE.
CONCLUSION: In patients with early-stage breast cancer treated with ICI, older age and the presence of CKD were risk factors of grade ≥3 irAE. Further studies to identify biomarkers of irAE are needed to prevent irAE and reduce the long-term complications.