Work

Risk Factors and Prediction Model for Early‐Onset Immune‐Related Adverse Events in Pan‐Cancer Patients Undergoing Anti‐ PD ‐(L)1 Therapy: A Retrospective Study in a Tertiary‐Level Hospital

Year: 2026

Type: article

Abstract: BACKGROUND: Anti-programmed death 1 (PD-1) and anti-programmed death ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) have changed the treatment landscape of many advanced malignancies. However, immune-related adverse events (irAEs) bring great challenges to clinical benefits. The prediction of irAEs is urgently demanded for early detection and intervention. METHODS: Patients in our center who received anti-PD-(L)1 immunotherapy between January 2019 and May 2023 were collected. Logistic least absolute shrinkage and selection operator (LASSO) regression analysis with 10-fold cross-validation was performed to identify the most relevant variables associated with irAEs. Multivariate logistic regression analysis was used to build a prediction model by introducing features selected in LASSO regression analysis. RESULTS: Overall, 680 eligible patients were included, of whom 330 patients were included in the irAEs group. In the irAEs group, 455 different irAEs were reported, of which 52 events were grade 3 or higher in severity. Endocrinal toxicities (174/680, 25.59%) were the most commonly reported irAEs. Through LASSO and logistic regression analysis, we developed a risk assessment model to predict the risk of irAEs based on basophil percentage (BASO%), hemoglobin (Hb), absolute lymphocyte count (ALC), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), blood urea nitrogen level (BUN), the Charlson comorbidity index (CCI) score, Eastern Cooperative Oncology Group Performance Status (ECOG PS), and hepatitis B/hepatitis B surface antigen carriers. The model had a C-index of 0.727, with good discrimination and calibration capabilities. CONCLUSION: The prediction model developed in our study can screen and monitor patients with high risk of developing irAEs. It may improve prognosis for pan-cancer patients receiving anti-PD-(L)1 immunotherapy.

Source: Cancer Medicine

DOI: 10.1002/cam4.71603