Does development of iraes suggest improved cancer treatment outcomes compared with nondevelopment of IRAEs

Does development of iraes suggest improved cancer treatment outcomes compared with nondevelopment of IRAEs?

Some data suggest that the occurrence of an IRAE predicts a better cancer response to ICPI treatment. The hypothesis is that the occurrence of an IRAE reflects better activation of the immune system. A meta-analysis with nivolumab in the treatment of melanoma showed a slightly better response rate (44%) in those who required immune-modulating agents to treat IRAEs compared with those who did not receive immune-modulating agents (36%). Another study with ipilimumab in patients with melanoma showed that an early IRAE predicted a better probability of an objective antitumor response; furthermore, all patients who achieved a complete response had more severe IRAEs. In patients treated with pembrolizumab for melanoma, the occurrence of vitiligo was also a predictor of an objective response. Patients who developed early IRAEs while being treated for NSCLC with nivolumab also showed a better objective response (37% versus 17%) and had longer progression-free survival (6.4 months versus 1.5 months). Further studies looking at the exact nature and mechanism of this relationship are needed.

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