Table 3

Characteristics and management of autoimmune disorder (AD) exacerbations and new immune-related adverse events (irAEs) on checkpoint inhibitors (CPI)

RCCUCOverall
AD flareNew
irAE
AD flareNew
irAE
AD flareNew
irAE
In all patients(n=58)(n=48)(n=106)
Total events, N (%)18 (31%)22 (38%)20 (42%)18 (38%)38 (36%)40 (38%)
Cumulative incidence, % (95% CI)
 At 3 months21 (11 to 33)22 (12 to 34)31 (19 to 45)17 (8 to 29)29 (20 to 38)22 (15 to 30)
 At 6 months21 (11 to 33)34 (21 to 47)38 (24 to 52)26 (14 to 39)32 (23 to 41)32 (23 to 41)
In patients with irAE(n=18)(n=22)(n=20)(n=18)(n=38)(n=40)
Median time from CPI start to event, days (range)76 (25–315)56 (2–305)33 (1–368)120 (12–443)61 (1–368)68 (2–443)
Severity of symptoms*, N (%)
 Grade 16 (33%)7 (32%)2 (10%)3 (17%)8 (21%)10 (25%)
 Grade 27 (39%)8 (36%)12 (60%)7 (39%)19 (50%)15 (38%)
 Grade 3–42 (11%)7 (32%)4 (20%)6 (33%)6 (16%)13 (33%)
 Unknown3 (17%)0 (0%)2 (10%)2 (11%)5 (13%)2 (5%)
Received topical corticosteroids, N (%)
 Yes9 (50%)0 (0%)3 (15%)2 (6%)12 (32%)2 (5%)
 No9 (50%)22 (100%)17 (85%)16 (94%)26 (68%)38 (95%)
Received systemic corticosteroids, N (%)
 Yes5 (28%)11 (50%)12 (60%)11 (61%)17 (45%)22 (55%)
 No13 (72%)11 (50%)8 (40%)7 (39%)21 (55%)18 (45%)
Received immunomodulatory agents†, N (%)
 Yes1 (6%)0 (0%)1 (5%)0 (0%)2 (5%)0 (0%)
 No17 (94%)22 (100%)19 (95%)18 (100%)36 (95%)40 (100%)
CPI management, N (%)
 Continued13 (72%)11 (50%)11 (55%)7 (39%)24 (63%)18 (45%)
 Temporarily discontinued3 (17%)8 (36%)5 (25%)6 (33%)8 (21%)14 (35%)
 Permanently discontinued2 (11%)3 (14%)4 (20%)5 (28%)6 (16%)8 (20%)
irAE outcome‡, N (%)
 Ongoing but controlled7 (39%)6 (27%)12 (60%)5 (28%)19 (50%)11 (28%)
 Ongoing but uncontrolled3 (17%)0 (0%)3 (15%)0 (0%)6 (16%)0 (0%)
 Resolved8 (44%)16 (73%)5 (25%)11 (61%)13 (34%)27 (68%)
 Unknown0 (0%)0 (0%)0 (0%)2 (11%)0 (0%)2 (5%)
  • *Only the worst grade for the same symptom is captured. No grade 5 events occurred.

  • †Two patients received one of the following treatments: methotrexate (polymyalgia rheumatica), rituximab (granulomatosis with polyangiitis).

  • ‡Controlled was defined as a now asymptomatic adverse event still requiring immunosuppression agents. Uncontrolled was defined as an irAE that was still symptomatic at the time of the analysis.

  • RCC, renal cell carcinoma; UC, urothelial carcinoma.