Association Between Immune-Related Adverse Events, Outcomes After ICIs for mUC

An analysis of individual patient data from the IMvigor210 and IMvigor211 trials sheds light on the association between immune-related adverse events (irAEs) and oncologic outcomes in patients receiving atezolizumab for advanced urothelial carcinoma.

While immune checkpoint inhibitors (ICIs) like atezolizumab have changed the treatment landscape for advanced urothelial carcinoma, predictors of response at the patient and tumor level remain poorly understood.

Presenting at the American Urological Association 2023 Annual Meeting, Daniele Robesti, MD, and colleagues attempted to better understand the association between irAEs and oncological outcomes in patients receiving ICIs, as well as whether the administration of systemic corticosteroids diminishes their impact. Data from 896 patients who received atezolizumab for locally advanced or metastatic urothelial carcinoma (mUC) in the IMvigor210 and IMvigor211 trials were analyzed.

The association between occurrence of irAEs and clinical progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) was tested, and patients experiencing irAEs were further stratified based on systemic corticosteroids administration.

Multivariable analysis showed that irAEs were inversely associated with the risk of disease progression (hazard ratio [HR], 0.50; 95% CI, 0.40-0.61; P<.001), overall mortality (HR, 0.51; 95% CI, 0.41-0.64; P<.001), and cancer-specific mortality (HR, 0.55; 95% CI, 0.45-0.72; P<.001).

Additionally, researchers found that administration of systemic corticosteroids was not associated with worse oncological outcomes (PFS: HR, 0.92; 95% CI, 0.62-1.34; P=.629; OS: HR, 0.86; 95% CI, 0.51-1.64; P=.613; CSS: HR, 0.90; 95% CI, 0.60-1.36; P=.630).

These results led Dr. Robesti and colleagues to conclude that the development of related irAEs while receiving atezolizumab was associated with improved oncological outcomes, and this correlation was not affected by systemic corticosteroid administration.