Prognostic differences in patients with advanced solid tumors receiving immune checkpoint inhibitors: The role of immune-related adverse events

This retrospective study examines the relationship between negative immune responses and the effectiveness of immune checkpoint inhibitors (ICIs) in the treatment of advanced solid tumors. A total of 59 patients with advanced solid tumors treated with ICIs between August 2020 and May 2022 were included. Based on the presence or absence of immune-related adverse events (irAEs), patients were categorized into 2 cohorts: irAE group (n = 46) and non-irAE group (n = 13). The primary objective was to compare therapeutic efficacy and survival outcomes between these cohorts. Among patients who developed immune-related adverse events (irAEs), the disease control rate (DCR) was 93.48% and the objective response rate (ORR) was 30.43%. In contrast, patients without irAEs exhibited significantly lower rates (DCR: 38.46%; ORR: 7.69%). Kaplan-Meier analysis demonstrated significantly prolonged progression-free survival (PFS) in the irAE group (median: 10.34 months; 95% CI: 9.275-11.401) compared to the non-irAE group (median: 5.82 months; 95% CI: 2.868-8.772; P < .05). Gastrointestinal malignancies (gastric cancer, HCC, and esophageal carcinoma) exhibited the most favorable PFS outcomes. Multivariate Cox regression analysis showed that irAEs, cutaneous irAEs, and endocrine irAEs were significantly associated with prolonged PFS. Multivariate Cox proportional hazards regression analysis identified irAE occurrence (hazard ratio [HR] = 0.542; 95% CI: 0.295-0.971; P = .04), cutaneous irAEs (HR = 0.476; 95% CI: 0.232-0.912; P = .03), and endocrine irAEs (HR = 0.237; 95% CI: 0.037-0.842; P = .02) as independent predictors of prolonged PFS. Among patients with advanced solid tumors treated with ICIs, those who experienced immune side effects had higher DCRs and ORRs and demonstrated superior PFS. The observed benefit was more pronounced in patients with gastric, esophageal, and hepatocellular cancers.