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      Evaluation of autoantibodies as predictors of treatment response and immune‐related adverse events during the treatment with immune checkpoint inhibitors: A prospective longitudinal pan‐cancer study

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          Abstract

          Background

          The presence of autoantibodies in the serum of cancer patients has been associated with immune‐checkpoint inhibitor (ICI) therapy response and immune‐related adverse events (irAEs). A prospective evaluation of different autoantibodies in different cancer entities is missing.

          Materials and Methods

          In this prospective cohort study, we included a pan‐cancer cohort of patients undergoing ICI treatment and measured a comprehensive panel of autoantibodies at treatment start and at the time point of first response evaluation. The presence and induction of autoantibodies (ANA, ENA, myositis, hepatopathy, rheumatoid arthritis) in different cancer entities were assessed and the association between autoantibodies and disease control rate (DCR), objective response rate (ORR), and progression‐free survival (PFS), as well as the development of grade 3 or higher irAEs were evaluated by logistic regression models, cox proportional hazard models, and Kaplan–Meier estimators.

          Results

          Of 44 patients with various cancer entities, neither the presence of any positive autoantibody measurement nor the presence of positive antinuclear antibodies (ANA) [≥1:80] at baseline was associated with the examined clinical endpoints (DCR, ORR, PFS) in univariable and multivariable analyses. After 8–12 weeks of ICI treatment, DCR, ORR, and PFS did not significantly differ between patients with and without any positive autoantibody measurement or positive ANA titers. The frequency of irAEs did not differ depending on autoantibody status of the patients.

          Conclusion

          Autoantibodies at treatment initiation or induction after 8–12 weeks of ICI treatment are not associated with treatment efficacy as indicated by DCR, ORR, and PFS or higher grade irAEs.

          Abstract

          Autoantibodies at treatment initiation or induction after 8‐12 weeks of ICI treatment are not as‐sociated with treatment efficacy as indicated by DCR, ORR and PFS or higher grade irAEs in a prospective longitudinal study.

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          Most cited references30

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          Pembrolizumab plus Chemotherapy for Squamous Non–Small-Cell Lung Cancer

          Standard first-line therapy for metastatic, squamous non-small-cell lung cancer (NSCLC) is platinum-based chemotherapy or pembrolizumab (for patients with programmed death ligand 1 [PD-L1] expression on ≥50% of tumor cells). More recently, pembrolizumab plus chemotherapy was shown to significantly prolong overall survival among patients with nonsquamous NSCLC.
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            Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma

            The combination of pembrolizumab and axitinib showed antitumor activity in a phase 1b trial involving patients with previously untreated advanced renal-cell carcinoma. Whether pembrolizumab plus axitinib would result in better outcomes than sunitinib in such patients was unclear.
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              Nivolumab plus Ipilimumab in Advanced Non–Small-Cell Lung Cancer

              In an early-phase study involving patients with advanced non-small-cell lung cancer (NSCLC), the response rate was better with nivolumab plus ipilimumab than with nivolumab monotherapy, particularly among patients with tumors that expressed programmed death ligand 1 (PD-L1). Data are needed to assess the long-term benefit of nivolumab plus ipilimumab in patients with NSCLC.
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                Author and article information

                Contributors
                martin.pichler@medunigraz.at
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                16 March 2022
                August 2022
                : 11
                : 16 ( doiID: 10.1002/cam4.v11.16 )
                : 3074-3083
                Affiliations
                [ 1 ] Division of Oncology Department of Internal Medicine, Medical University of Graz Graz Austria
                [ 2 ] Division of Haematology Department of Internal Medicine, Medical University of Graz Graz Austria
                [ 3 ] Department of Orthopaedics and Trauma Medical University of Graz Graz Austria
                [ 4 ] Department of Urology Medical University of Graz Graz Austria
                [ 5 ] Otto Loewi Research Center Division of Pharmacology, Medical University of Graz Graz Austria
                [ 6 ] BioTechMed‐Graz Graz Austria
                [ 7 ] Division of Rheumatology Department of Internal Medicine, Medical University of Graz Graz Austria
                [ 8 ] Department of Experimental Therapeutics The University of Texas MD Anderson Cancer Center Houston Texas USA
                Author notes
                [*] [* ] Correspondence

                Martin Pichler, Medical University of Graz, Department of Internal Medicine, Division of Oncology, Auenbruggerplatz 15, A‐8036 Graz, Austria.

                Email: martin.pichler@ 123456medunigraz.at

                Author information
                https://orcid.org/0000-0003-0812-3024
                https://orcid.org/0000-0002-3888-5401
                https://orcid.org/0000-0002-8701-9462
                Article
                CAM44675 CAM4-2021-12-5075.R2
                10.1002/cam4.4675
                9385593
                35297215
                b4411cf0-6f32-4be3-9108-d6810c3f82d0
                © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 February 2022
                : 01 December 2021
                : 04 March 2022
                Page count
                Figures: 2, Tables: 4, Pages: 10, Words: 5738
                Funding
                Funded by: Austrian Science Fund , doi 10.13039/501100002428;
                Award ID: Hertha‐Firnberg Grant T1112‐B
                Categories
                Research Article
                RESEARCH ARTICLES
                Clinical Cancer Research
                Custom metadata
                2.0
                August 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:17.08.2022

                Oncology & Radiotherapy
                autoimmunity,cancer,immune checkpoint inhibitor therapy,immune‐related adverse events,monoclonal antibodies

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