Table 1 Comparison of immune-related adverse events, intercurrent events and complications of tumor progression admissions
IrAE (n = 29) | IntE (n = 39) | TumProg (n = 44) | |
|---|---|---|---|
Demographics and comorbidities | |||
Sex = M (n, %) | 19 (66) | 22 (56) | 27 (61) |
Age (median [IQR]) | 62.7 [52.9–71] | 67.5 [61.9–74.1] | 57.8 [45.5–67.8] |
Comorbidities (n, %) | |||
Hypertension | 11 (38) | 25 (64) | 13 (30) |
Diabetes | 4 (14) | 6 (15) | 3 (7) |
Cardiac failure | 3 (10) | 5 (13) | 4 (9) |
COPD | 1 (3) | 6 (15) | 4 (9) |
Thromboembolic venous disease | 5 (17) | 7 (18) | 7 (16) |
Smoking status (n, %) | |||
Never | 10 (34) | 9 (23) | 15 (34) |
Past | 6 (21) | 10 (26) | 9 (21) |
Active | 13 (45) | 20 (51) | 20 (46) |
Weight loss (> 5 kg in the 3 preceding month) (n, %) | 6 (21) | 10 (26) | 15 (34) |
Performance status (n, %) | |||
≤ 2 | 23 (79) | 31 (79) | 30 (68) |
> 2 | 2 (7) | 8 (21) | 9 (20) |
BMI (kg/m2) (median [IQR]) | 24.8 [22.3–28.9]* | 23.2 [21.1–27.8] | 21.1 [19–24.7]* |
Length of symptoms before admission (days) (median [IQR]) | 7 [3, 14]* | 2 [0–4]** | 2 [1–8.5] |
Oncological characteristics | |||
Primary tumor site (n, %) | |||
Colorectal adenocarcinoma | 0 (0) | 1 (3) | 1 (2) |
Endometrial carcinoma | 0 (0) | 1 (3) | 2 (5) |
Prostate cancer | 0 (0) | 0 (0) | 1 (2) |
Ovarian cancer | 1 (3) | 2 (5) | 0 (0) |
Breast cancer | 0 (0) | 0 (0) | 2 (5) |
Cervical cancer | 0 (0) | 0 (0) | 3 (7) |
Squamous cell carcinoma | 0 (0) | 0 (0) | 1 (2) |
Esophagus cancer | 0 (0) | 0 (0) | 1 (2) |
Head and neck carcinoma | 0 (0) | 9 (23) | 6 (14) |
Urothelial carcinoma | 5 (17) | 7 (18) | 4 (9) |
Non-small cell lung cancer | 7 (24) | 12 (31) | 13 (30) |
Small cell lung cancer | 0 (0) | 0 (0) | 1 (2) |
Hodgkin lymphoma | 1 (3) | 0 (0) | 0 (0) |
Melanoma | 14 (48) | 7 (18) | 9 (20) |
Thymoma | 1 (3) | 0 (0) | 0 (0) |
State at admission (n, %) | |||
Localized | 0 (0) | 2 (5) | 0 (0) |
Locoregional | 4 (14) | 6 (15) | 3 (7) |
Metastatic | 23 (79) | 31 (79) | 41 (93) |
Number of metastatic sites (median [IQR]) | 2 [1, 3] | 2 [1, 3] | 2 [1, 3] |
Length from diagnosis (months) (median [IQR]) | 13.5 [6.3–30.1] | 16.6 [5.7–29.3] | 16 [11.3–27.5] |
Number of previous chemotherapeutic lines (median [IQR]) | 1 [0–1] | 1 [0–2] | 1 [1, 2] |
Immune checkpoint inhibitors (n, %) | |||
Anti-PD-1 | |||
NIVOLUMAB | 9 (31) | 19 (49) | 22 (50) |
PEMBROLIZUMAB | 7 (24) | 13 (33) | 8 (18) |
SPARTALIZUMAB | 0 (0) | 1 (3) | 1 (2) |
Anti-PDL-1 | |||
ATEZOLIZUMAB | 1 (3) | 2 (5) | 0 (0) |
AVELUMAB | 0 (0) | 2 (5) | 2 (5) |
DURVALUMAB | 1 (3) | 1 (3) | 4 (9) |
Anti-CTLA4 | |||
IPILIMUMAB | 5 (17)* | 1 (3) | 2 (5) |
TREMELIMUMAB | 0 (0) | 0 (0) | 1 (2) |
Anti-CTLA4/Anti-PD-1: IPILIMUMAB/NIVOLUMAB | 6 (21* | 0 (0) | 4 (9)* |
Length from ICI initiation and ICU admission (days) (median [IQR]) | 56 [30–84] | 68 [20.5–199.5] | 43.5 [19–88.5] |
Length from last ICI dose (days) (median [IQR]) | 14 [17, 22] | 14.5 [8.3–25.5] | 15.5 [6.3–27.8] |
Clinical and biological characteristics at ICU admission | |||
Blood pressure (systolic) (median [IQR]) | 129 [112.5–146] | 124 [91–146.5] | 123 [109.5–132.5] |
Blood pressure (diastolic) (median [IQR]) | 72 [60–82.5] | 69 [59–90.5] | 71 [64.5–81] |
Respiratory rate (median [IQR]) | 24 [19, 29] | 21 [18–26.5] | 22.5 [18, 25] |
SpO2 (median (IQR) | 97 [94.5–98] | 96 [93–98.8] | 97 [95–99] |
Glasgow score for coma (median [IQR]) | 15 [14.8–15] | 15 [13, 15] | 15 [15–15] |
SOFA Day 1 (median [IQR]) | 2 [1, 4] | 4 [1, 6] | 3 [3, 5] |
Leucocytes (G/L) (median [IQR]) | 8.5 [6.5–16.1] | 11.9 [7.4–18] | 14.4 [8.7–19.2] |
Neutrophils (G/L) (median [IQR]) | 5.3 [3.9–13.9]* | 10.2 [6.1–16.2]* | 12.3 [7–17.8]* |
Lymphocytes (G/L) (median [IQR]) | 1 [0.8–1.6] | 0.7 [0.5–1.6] | 0.8 [0.4–1.4] |
Neutrophil/Lymphocyte ratio (median [IQR]) | 6 [3.6–15.5]* | 11.9 [5.5–23.3] | 14.2 [6.2–22.4]* |
Hemoglobin (g/dL) (median [IQR]) | 11.7 [10.3–13.2]* | 11 [10.2–12] | 9.9 [8.6–11.3]** |
Platelets (G/L) (median [IQR]) | 305.5 [214.3–402.3] | 271 [209.5–375.8] | 288.5 [211.8–384] |
Fibrinogen (g/L) (median [IQR]) | 4.7 [3.5–6] | 5.1 [4.3–5.7] | 5.5 [3.6–6.9] |
Prothrombin Time (%) (median [IQR]) | 83 [74–91]* | 74 [61–88] | 70.5 [60–85]* |
Creatinine (µM) (median [IQR]) | 106.5 [67–177.5]* | 86 [59.3–148] | 64 [54–97]* |
Nitrogen (mM) (median [IQR]) | 9.1 [6.7–14.8] | 8 [5.5–11.5] | 7.7 [5.7–11.1] |
Lactate (mM) (median [IQR]) | 1.7 [1.2–2.6] | 2 [1.4–3.2] | 2.4 [1.5–3.8] |
pH (median [IQR]) | 7.4 [7.3–7.4] | 7.4 [7.3–7.4] | 7.4 [7.3–7.4] |
Bilirubin (µM) (median [IQR]) | 8 [6, 12] | 10 [7, 14] | 10 [7–15.5] |
Treatments in ICU and outcomes | |||
ICU length of stay (days) (median [IQR]) | 4 [1.3–8] | 2 [1, 4] | 3 [1.1–5.3] |
Vasopressor therapy (n, %) | 7 (24) | 16 (41) | 12 (27) |
Mechanical ventilation (n, %) | 6 (21) | 12 (31) | 13 (30) |
Length of mechanical ventilation (days) (median [IQR]) | 8 [5.8–14.8] | 2.5 [2–3.3]* | 5 [2, 8]* |
Non-invasive ventilation (n, %) | 7 (24) | 8 (21) | 9 (21) |
Renal replacement therapy (n, %) | 3 (10) | 1 (3) | 2 (5) |
CVVHF | 1 (3) | 0 (0) | 1 (2) |
Hemodialysis | 2 (7) | 1 (3) | 1 (2) |
Steroids (n, %) | 18 (62)* | 4 (10)** | 17 (39) |
ICU mortality (n, %) | 5 (17) | 9 (23) | 16 (36) |
Limitations during ICU stay (n, %) | 4 (14) * | 11 (28) | 21 (48)* |
Discontinuation of ICI (n, %) | 18 (62) | 22 (56) | 30 (68) |
One-year mortality (n, %) | 10 (42) | 21 (66) | 36 (88) |
* = p < 0.05 ** = p < 0.001 against Others | * = p < 0.05 ** = p < 0.001 against irAE | * = p < 0.05 ** = p < 0.001 against irAE | |