{
  "abstract": "Background Immune checkpoint inhibitors (ICIs), have revolutionized cancer treatments by enhancing the immune system’s ability to target tumors including melanoma. However, these can lead to serious immune-related adverse events (irAEs) leading to significant morbidity. Melanoma patients with liver metastasis generally have poor prognosis, and tumor microenvironment in metastatic liver disease is poorly understood. This project aims to elucidate outcomes for melanoma patients treated with ICIs depending on the timing of liver metastases, as there is no data about this.Methods Melanoma patients with liver metastasis treated with ICIs within the Brown University Health hospital system (previously Lifespan) from 2005 to 2024 were retrospectively chart reviewed. Patients were divided into those with liver metastasis present at the time of cancer diagnosis and melanoma patients who later developed liver metastasis. Primary endpoints including irAE types, grading of irAE, hospitalization from toxicity, and toxicity events based on ICI agent. These were analyzed using Chi-squared and Fisher’s exact test with significance level defined as α = 0.05.Results Of the 335 patients with metastatic melanoma treated with ICIs, 48 had liver metastases. Metastases were present at diagnosis for 26 patients; 22 patients developed metastasis later. A total of 84 treatment episodes were analyzed, during which 72 irAEs were reported. Sixteen events occurred in those with metastases at diagnosis while 56 occurred with those diagnosed later. Table 1 outlines the toxicities between the two groups. While the frequency of irAEs did not differ between the two groups (p = .2244), there was a significant difference in the types of toxicities (p = .0342) excluding irAEs classified as ‘other’. There was no difference in grading of toxicity between groups (i.e., No toxicity vs. G1/2 vs. G3+, p=.1562). ICI agents with toxicities include combination ipilimumab and nivolumab, nivolumab monotherapy, pembrolizumab, and combination relatimab and nivolumab. Regarding hospitalization for an irAE, in patients with liver metastases present at diagnosis, 75% of treatment episodes required hospitalization, versus 24% of treatment episodes resulted in hospitalization in those who developed liver metastasis at a later time (p = 0.0105).Conclusions Our findings suggest that ICI therapy in melanoma patients with liver metastasis at diagnosis compared to those who later develop liver metastasis experience different irAEs, however the frequency was not different. Additionally, liver metastasis at the time of diagnosis led to higher hospitalization rates, indicating a higher morbidity. Future directions include comparing melanoma patients treated with ICIs with other sites of metastasis.Abstract 1063 Table 1Reported irAEs between liver metastasis at diagnosis time versus later development of metastases. Endocrinopathies include hypothyroidism, adrenal insufficiency, and hypophysitis. Other include uveitis, fatigue, and pancreatitis",
  "authors": [
    {
      "affiliations": [
        "Brown University Health, Providence, RI, USA"
      ],
      "name": "Kaavya Mandi"
    },
    {
      "affiliations": [
        "Brown University Health, Providence, RI, USA"
      ],
      "name": "Charmi Trivedi"
    },
    {
      "affiliations": [
        "Warren Alpert Medical School of Brown University, Providence, RI, USA"
      ],
      "name": "Victoria Gill"
    },
    {
      "affiliations": [
        "Brown University Health, Providence, RI, USA"
      ],
      "name": "Bridget Harrop"
    },
    {
      "affiliations": [
        "Warren Alpert Medical School of Brown University, Providence, RI, USA"
      ],
      "name": "Justine Elshama"
    },
    {
      "affiliations": [
        "Warren Alpert Medical School of Brown University, Providence, RI, USA"
      ],
      "name": "Julia Contini"
    },
    {
      "affiliations": [
        "Brown University Health, Providence, RI, USA"
      ],
      "name": "Hetal Mistry"
    },
    {
      "affiliations": [
        "Brown University Health, Providence, RI, USA"
      ],
      "name": "Matthew J Hadfield"
    }
  ],
  "title": "1063 Outcomes in immune-related adverse events in melanoma patients with liver metastasis treated with immune checkpoint inhibitors: a retrospective analysis",
  "uid": "746ea5a1-5d42-5417-bf4d-afb84eaaa10a"
}