Title:Occurrence and Severity of Adverse Reactions of Immune Checkpoint
Inhibitors (PD-1 and PD L1) Based on Mordovian Dispensary Data
Analysis
Volume: 18
Issue: 1
Author(s): Basheer Marzoog*
Affiliation:
- National Research Mordovia State University, Saransk, Republic of Mordovia, Russia
Keywords:
Immunotherapy, checkpoint inhibitors, PD-L1 & PD-1, atezolizumab, pembrolizumab, nivolumab.
Abstract:
Background: Recently, a novel therapeutic technique has been revealed to recruit PDL1
and PD1 inhibitors to promote and enhance the cytotoxic T cell activity in combating the tumor.
But unfortunately, several followed patients who didn’t tolerate the drug appeared unfavorable
autoimmune side effects, such as anemia, pneumonitis, hepatitis, colitis, in addition to fatigue/
asthenia, decreased appetite, nausea, cough, dyspnea, constipation.
Aim: To assess the severity of the adverse reactions of PD-1 and PD-L1 inhibitors in treating patients
with positive PD-1 or PD-L1; non-small cell lung cancer patients (NSCLCs), small cell lung
cancer (SCLC), nodular sclerosis Hodgkin lymphoma, classic Hodgkin's lymphoma, gastric cancer,
renal cell carcinoma, caecal carcinoma, buccal mucosa carcinoma, nasopharyngeal carcinoma,
laryngopharynx cancer, bladder cancer, cervical cancer, and melanoma.
Materials and Methods: The study data was collected and analyzed randomly from the period of
January 2019 to November 2020 from the Mordovian oncological dispensary. The data are collected
from the electronic archive of the hospital. Then, we followed up with the patients for the same
period, and we recorded the presented adverse reactions. The patients received anti-tumor drug;
PD-L1/PD-L inhibitors (Atezolizumab; 1200mg, Pembrolizumab; 200mg, and Nivolumab; 240mg
or 3 mg/kg) every 21 or 14 days they got IV infusion of PD-1 and/or PD-L1 inhibitors. After the
progression and metastasis of the tumor, the patients received a combination of chemotherapy prior
to the immunotherapy.
Results: The analyzed data have shown 7.14% of the studied patients (n=28) have developed adverse
reactions that ranged from mild to moderate severity (anemia and biochemical tests deviation).
Conclusion: These clinical findings supported the moderate risk of developing life-threatening adverse
reactions after administration of immune checkpoint inhibitors (Nivolumab, Pembrolizumab,
Atezolizumab) to patients with advanced-stage tumors. The patients who were treated with PD-1 inhibitors
developed less severe adverse reactions than patients who were treated with PD-L1 inhibitors.
The adverse reaction severity depends on the period of administration and the type of the treated
tumor, which consequently determines the dose of immunotherapy. Also, the aggressiveness of
the autoimmune reactions depends on the patient's immune state and its reactivity.
