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Background <p>Up to half of cancer patients treated with immune checkpoint inhibitors (ICIs) develop immune-related adverse events (irAEs). However, the long-term consequences of irAEs remain poorly characterized.</p> Objective <p>This study investigated the likelihood of chronic irAEs, challenges related to their corticosteroid treatment and clinical workload associated with their management.</p> Methods <p>We retrospectively analyzed 230 patients who received ICIs at Kuopio University Hospital, Finland, between the years 2015 and 2024.</p> Results <p>IrAEs were chronic in 60.9% of patients who developed toxicities. Thyroiditis was the most common chronic AE (40%). Of the patients with irAE+, 42.9% were treated with systemic corticosteroids and steroid-related AEs were observed in 58% of them. Corticosteroid usage for ≥&#xa0;3&#xa0;months was associated with an increased risk of steroid-related AEs (&lt;&#xa0;3&#xa0;months 38.2% vs ≥&#xa0;3&#xa0;months 78.8%, <i>p</i>&#xa0;&lt;&#xa0;0.001). An average of 5.3 contacts with a medical oncologist was needed for the management of an irAE, with the highest workload associated with hepatitis (10.0 contacts/irAE) and colitis (6.1 contacts/irAE).</p> Conclusions <p>The characterization of the long-term sequelae of irAEs and the associated clinical workload is crucial for proper patient education and clinical resource planning.</p>

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The Long-Term Sequelae and Clinical Workload Resulting from Toxicities of Immune Checkpoint Inhibitor (ICI) Therapy in Patients with Cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Veera Nurmela,
  • Anni Juntunen,
  • Satu Tiainen,
  • Janne Martikainen,
  • Sanna Pasonen-Seppänen,
  • Aino Rönkä

摘要

Background

Up to half of cancer patients treated with immune checkpoint inhibitors (ICIs) develop immune-related adverse events (irAEs). However, the long-term consequences of irAEs remain poorly characterized.

Objective

This study investigated the likelihood of chronic irAEs, challenges related to their corticosteroid treatment and clinical workload associated with their management.

Methods

We retrospectively analyzed 230 patients who received ICIs at Kuopio University Hospital, Finland, between the years 2015 and 2024.

Results

IrAEs were chronic in 60.9% of patients who developed toxicities. Thyroiditis was the most common chronic AE (40%). Of the patients with irAE+, 42.9% were treated with systemic corticosteroids and steroid-related AEs were observed in 58% of them. Corticosteroid usage for ≥ 3 months was associated with an increased risk of steroid-related AEs (< 3 months 38.2% vs ≥ 3 months 78.8%, p < 0.001). An average of 5.3 contacts with a medical oncologist was needed for the management of an irAE, with the highest workload associated with hepatitis (10.0 contacts/irAE) and colitis (6.1 contacts/irAE).

Conclusions

The characterization of the long-term sequelae of irAEs and the associated clinical workload is crucial for proper patient education and clinical resource planning.