High body mass index and pre-existing autoimmune disease are associated with an increased risk of immune-related adverse events in cancer patients treated with PD-(L)1 inhibitors across different solid tumors

BACKGROUND\nPATIENTS AND METHODS\nRESULTS\nCONCLUSION\nTreatment with anti-PD-(L)1 antibodies, approved for several oncology indications, can lead to immune-related adverse events (irAEs). We aimed to investigate risk factors associated with an increased reporting of irAEs in patients treated with PD-(L)1 inhibitors approved for solid tumor indications.\nA retrospective review was performed of individual data from patients in phase II/III registrational studies for PD-(L)1 inhibitors in solid tumors. Data on baseline characteristics and adverse events were extracted. Univariate and multivariable logistic regression models were used to identify risk factors.\nIn total, 5123 patients were included from 15 studies reporting on the use of four PD-(L)1 inhibitors for five solid tumor indications. Univariate analysis suggested that type of study drug (P 2 [odds ratio (OR) 1.5, 95% confidence interval (CI) 1.2-1.8] in comparison to normal BMI, having an autoimmune disease at baseline (OR 1.8, 95% CI 1.1-2.7), and use of a PD-L1 inhibitor (OR 1.6, 95% CI 1.2-2.0). The latter finding is probably biased due to the selection of the studies in the dataset with complete information on baseline characteristics.\nThis study was conducted using a large dataset of individual patient data from clinical trials comprising multiple solid tumor indications. We demonstrated that patients with obesity and concurrent autoimmune disease were at increased risk of developing irAEs.FWN – Publicaties zonder aanstelling Universiteit Leide

Are there parameters that predict a nondiagnostic biopsy outcome taken during laparoscopic-assisted cryoablation of small renal tumors?

Background and Purpose: The histopathologic diagnosis of a small renal mass (SRM) that is managed with cryoablation relies on preoperative or intraoperative biopsies. Because a considerable number of these SRMs are benign, accurate diagnosis has prognostic and follow-up implications. The main problem in SRMs is the high rate of nondiagnostic biopsies. Our purpose was to assess whether certain tumor and biopsy characteristics are correlated with a diagnostic biopsy outcome. Patients and Methods: One hundred tumors that were smaller than 4.5¿cm in 94 patients were managed with laparoscopic cryoablation. After dissection of the perirenal fat and identification of the tumor by intra-abdominal ultrasonography, one or more biopsies were obtained before freezing. Using the Student t/Mann Whitney U test, the following parameters were evaluated for predicting biopsy outcome: Tumor size, location, and exophytic part of the tumor, size of the biopsy needle, the number of biopsies taken, and presence of nonenhancing areas compatible with necrosis inside the tumors. Correlations among parameters were assessed using a Spearman correlation or Kruskal-Wallis test. Results: Twenty-two (22%) biopsies were nondiagnostic and consisted of normal kidney tissue, connective tissue, fat, fibrosis, necrosis, and/or blood. There were no significant differences in parameters between the diagnostic and nondiagnostic group. There was a positive correlation between tumor size and number of biopsies (P=0.029) and between the presence of nonenhancing areas and both size (