Increasing the understanding behind treatment response and immune-related adverse events in cancer patients treated with immune checkpoint inhibitor therapies
Kaiku Health and Oulu University Hospital (OYS) aim to increase the understanding behind treatment benefit and onset of complex immune-related adverse events (irAEs) associated with immune checkpoint inhibitor (ICI) therapies. The findings from this study conducted together with Kaiku and OYS are currently being presented in the prestigious ESMO 2020 Virtual Congress.
There has been a remarkable development in cancer ICI therapies, however, the downside is that they are associated with novel immune-related adverse events (irAEs) and only a subset of patients benefit from ICIs. ICIs may also be associated with unexpected tumor response patterns such as pseudo- and hyper-progression, and the temporal association to treatment may sometimes be obscure.The factors and mechanisms behind treatment responses and irAEs are not currently understood.
It would be of utmost importance to find out the predictive factors behind the sometimes even extremely good responses, as well as the unique irAEs not seen together with other forms of cancer treatment. This would enable better selection of patients to the treatment, maximising the potential benefit and minimising the number of patients suffering from severe adverse events that worsen the quality of life of the patient and may even be life-threatening.
In this freshly published research, Kaiku and OYS looked at the correlations of patient-reported symptoms and laboratory measurements with prospectively collected diagnosed irAEs and investigator-assessed treatment responses. The data was collected from 33 patients during their ICI treatment. This study found many clinically interesting correlations to the treatment response and onset of irAEs. Increases in Alanine Aminotransferase (ALT), Alkaline phosphatase (ALP) and creatinine correlated positively with clinical benefit and increases in thyrotropin correlated strongly with clinical benefit. From symptoms, itching, nausea and dizziness correlated positively with clinical benefit. When it comes to irAEs, ALP, leukocytes and neutrophils correlated positively with irAEs while nausea had a negative correlation. Rash and increases in thyrotropin correlated notably with the upcoming onset of irAEs.
Kaiku hopes to continue this research by building a machine learning (ML) based tool to make early detection of irAEs and predicting treatment response with high performance. However, already today Kaiku has the potential as a tool to improve the safety of ICI treated patients by implementing a comprehensive assessment, grading and long-term surveillance of symptoms of ICI patients with Kaiku as part of their routine care.
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