{
  "abstract": "Background Immune checkpoint inhibitors (ICIs) have revolutionized the management of many malignancies, including melanoma, renal cell carcinoma (RCC), and urothelial cancers. However, these agents are often accompanied by a unique and sometimes severe spectrum of immune-related adverse events (IRAEs), which impose a challenge in the face of clinicians. These challenges underscore the need to establish clear predictors of treatment response and toxicity, ultimately optimizing the clinical application of ICIs in cancer therapy.Methods Patients with melanoma, RCC, or bladder cancer who received ICIs at a major referral center from the MENA region were retrospectively reviewed. Patient characteristics, tumor features, treatment response, and IRAEs details were recorded. Binary logistic regressions assessed the relationships between predictors and outcomes. The aim of our study was to study the association of different predictors with system-specific toxicities.Results 146 patients were enrolled; the mean age was 67.6±13.6 years. The primary diagnoses were Renal Cell Carcinoma (31%), Bladder Cancer (31%), and Melanoma (38%). 65 patients (45%) experienced ≥ 1 IRAEs with a total of 122 IRAEs. The most common systems involved were gastrointestinal (17.2%), dermatologic (12.6%), pulmonary (11.8%), endocrine (11.7%), and renal (9.7%). Our analysis showed that a longer radiotherapy period (p= 0.013) and higher cancer stage (p= 0.043) were significant predictors of GI IREAs, while older age (p= 0.034) and greater BMI (p= 0.016) were protective against GI IREAs. Additionally, primary diagnoses (p= 0.032), poorer ECOG performance status (p=0.008), older age (p=0.048) and higher Charleson comorbidity index (CCI) (p= 0.046) were significant predictors of renal IRAEs. As for dermatological IRAEs, only Chemotherapy (p = 0.031) and cancer stage (p=0.006) were significant predictors. Gender was shown to be a significant predictor of endocrinological IRAEs, with women being more susceptible to toxicity (p= 0.004). Lastly, ECOG performance status (p= 0.007) and CCI were significantly associated with pulmonary toxicity (p= 0.025). At the multivariate level, only age and BMI remained significantly associated with GI toxicity.Conclusions This data highlights the importance of assessing patients’ characteristics in order to predict any possible immune-related toxicity across all different organ systems. Age, gender, ECOG functional status, BMI, disease stage, and prior treatments were all shown to play crucial role in shaping IRAEs risk stratification.Ethics Approval Since this is a retrospective study, informed consent was waived, and the study was approved by the Institutional Review Board (IRB) of the American University of Beirut (AUB).",
  "authors": [
    {
      "affiliations": [
        "Beirut, Lebanon"
      ],
      "name": "Ali Awada"
    },
    {
      "affiliations": [
        "American University of Beirut Medical Center, Beirut, Lebanon"
      ],
      "name": "Abbas Hammoud"
    },
    {
      "affiliations": [
        "American University of Beirut Medical Center, Beirut, Lebanon"
      ],
      "name": "Mohamad Al Hajjar"
    },
    {
      "affiliations": [
        "American University of Beirut Medical Center, Beirut, Lebanon"
      ],
      "name": "Ali Dakik"
    },
    {
      "affiliations": [
        "American University of Beirut Medical Center, Beirut, Lebanon"
      ],
      "name": "Michael Romanos"
    },
    {
      "affiliations": [
        "American University of Beirut Medical Center, Beirut, Lebanon"
      ],
      "name": "Razane Wehbe"
    },
    {
      "affiliations": [
        "University of Balamand, Beirut, Lebanon"
      ],
      "name": "Ali Tarhini"
    },
    {
      "affiliations": [
        "American University of Beirut Medical Center, Beirut, Lebanon"
      ],
      "name": "Firas Kreidieh"
    }
  ],
  "title": "1067 Organ-specific predictors of IRAEs in ICI-treated cancer patients: a retrospective cohort study from the MENA region",
  "uid": "cdf7f59e-7956-5ecd-8ef0-78eaf5d4b7a8"
}