ADVERTISEMENT
Outcomes Among Patients Treated With Immune Checkpoint Inhibitors in the Inpatient Setting
Clinical outcomes from a multi-institutional study analyzing patient outcomes following inpatient immune checkpoint inhibitor (ICI) therapy “should give clinicians pause when considering inpatient ICI use,” according to Fauzia Riaz, MD, MHS (Stanford University, Division of Oncology, Stanford, CA), and colleagues. These findings were presented at the 2022 ASCO Quality Care Symposium in Chicago, IL.
While ICIs have changed the landscape of care among patients with cancer, the time to response is 2 to 6 months and many patients do not benefit from ICIs. Findings from recent studies have shown limited benefit of anticancer therapy at end of life, and ICIs are associated with significant financial toxicity.
Dr Riaz and colleagues aimed to identify the role of ICI therapy in the inpatient setting by conducting the Inpatient Immunotherapy Outcomes Study (IIOS), describing characteristics and outcomes of patients who received inpatient ICIs.
Authors conducted IIOS, a multicenter, retrospective study, by examining patients treated with PD-(L)1 and CTLA-4 inhibitors during inpatient hospitalization between 2012 to 2021. Data from Mount Sinai Hospital, Yale-New Haven Hospital, University of Pennsylvania, and Georgetown University Hospital were used for this study.
Among the 159 patients included in this study, 54.7% were White, 17.6% were Black, and 12.6% were Hispanic, and the median age was 61 years. In this study, thoracic/head and neck malignancies were present in 26.4% of participants, gastrointestinal malignancies were present in 19.5%, and hematologic malignancies in 17.6%. Data showed that 73% of patients initiated ICI in the inpatient setting while 27% continued an outpatient ICI regimen. Stage IV solid malignancies at the time of ICI initiation in any setting were present in 81.1% of patients. Prior lines of systemic therapy ranged between 0 to 11, but the median among all participants was 1.
“Preliminary data…is concerning for poor clinical outcomes which should give clinicians pause when considering [inpatient] ICI use,” wrote Dr Riaz and colleagues, adding, “Further analysis is ongoing to determine predictors of overall survival and discharge to home.”
Source
Riaz F, Zhu H, Cheng W, et al. The Inpatient Immunotherapy Outcomes study: A multicenter retrospective study of patients treated with immune checkpoint inhibitors in the inpatient setting. Presented at: the 2022 ASCO Quality Care Symposium; September 30-October 1, 2022; Chicago, IL, and virtual; Abstract 300.
