Efficacy and toxicity of immune checkpoint inhibitors: A retrospective analysis from a single institution in Eastern India

ABSTRACT Background: Immune checkpoint inhibitors (ICIs) have transformed the management of several solid malignancies. Real-world data—particularly from low- and middle-income countries—remain limited and are essential to understand outcomes across heterogeneous patient populations. Objectives: Our primary objective was to assess overall survival (OS) in patients with solid tumors treated with immune checkpoint inhibitors. The secondary objective was to evaluate progression-free survival (PFS) and treatment-related toxicities. Materials and Methods: We retrospectively analyzed patients receiving immune checkpoint inhibitors (ICIs) in the Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, between 2017 and 2023. Data collected included demographics, comorbidities, prior treatments, use of radiotherapy, Programmed Death-Ligand 1 (PD-L1) status, line and type of immunotherapy, number of cycles received, treatment-related toxicities, disease progression, and survival outcomes. The Kaplan–Meier method was used to estimate OS and PFS, and survival differences were analyzed using the log-rank test. Results: Eighty-five patients were included. Head-and-neck squamous cell carcinoma was the most common malignancy (43 patients, 50.6%), followed by lung cancer (12 patients, 14.1%) and malignant melanoma (4 patients, 4.7%). With a median follow-up of 24 months (range: 1–35.5), the median OS was 24 months (95% CI: 12.5–35.5) and the median PFS was 19 months (95% CI: 12.5–25.4). Grade ≥3 treatment-related toxicities were observed in 8 patients (9.4%). Conclusion: This real-world analysis demonstrates that immune checkpoint inhibitors provide meaningful survival benefits with an acceptable toxicity profile, supporting their effective and feasible use in routine oncology practice in eastern India.