Autoimmune Effects of Lung Cancer Immunotherapy Revealed by Data-Driven Analysis on a Nationwide Cohort.
Shihao YangKun-Hsing YuNathan PalmerKathe FoxS C KouIsaac S KohanePublished in: Clinical pharmacology and therapeutics (2019)
The autoimmune adverse effects of lung cancer immunotherapy are not fully understood at the population level. Using observational data from commercial health insurance claims, we compared autoimmune diseases risk of immune checkpoint inhibitors (including pembrolizumab and nivolumab) and that of chemotherapy using the matching method. By 6 months after treatment initialization, the cumulative incidence of new autoimmune diseases among patients receiving immunotherapy was 13.13% (95% confidence interval (CI), 10.79-15.50%) and that of the matched chemotherapy patients was 6.65% (95% CI, 5.79-7.50%), constituting a hazard ratio (HR) of 1.97 (95% CI, 1.58-2.48). Both pembrolizumab (HR = 2.06 (95% CI, 1.20-3.65), P = 0.0032) and nivolumab (HR = 1.76 (95% CI, 1.39-2.24), P < 0.0001) were associated with higher risks of developing autoimmune diseases, especially for hypothyroidism (P < 0.0001). Our findings suggest the need to monitor autoimmune side effects of immunotherapy.
Keyphrases
- health insurance
- multiple sclerosis
- end stage renal disease
- affordable care act
- chronic kidney disease
- locally advanced
- ejection fraction
- advanced non small cell lung cancer
- peritoneal dialysis
- risk factors
- drug induced
- electronic health record
- radiation therapy
- replacement therapy
- risk assessment
- big data
- human health
- patient reported outcomes
- climate change
- deep learning
- smoking cessation