New research in JNCCN sheds light on multi-organ adverse events from immunotherapy

September 08, 2020

PLYMOUTH MEETING, PA [September 8, 2020] -- New international research in the September 2020 issue of JNCCN--Journal of the National Comprehensive Cancer Network adds important knowledge about how immunotherapy-related adverse events (irAEs) can impact more than one organ in a single patient. This study provides new information on how frequently multiple organ side effects occur, and reveals that multi-organ irAEs are more likely to happen sequentially rather than simultaneously.

"Multi-organ irAEs are under-recognized, under reported, and their pathophysiology is poorly understood," said lead researcher Ganessan Kichenadasse, MBBS, FRACP, Flinders Centre for Innovation in Cancer, Flinders University, in Bedford Park, Australia. "We need a concerted international effort to improve our understanding and help identify predisposing factors and prevention strategies. Treating teams should be aware of the potential for irAEs which affect multiple organs and institute plans for recognizing and managing them."

The researchers evaluated the incidence and patterns of multi-organ irAEs using individual patient data from four non-small cell lung cancer trials where patients were treated with atezolizumab, a PD-L1 inhibitor. Those four studies, known as OAK, POPLAR, BIRCH, and FIR, include investigators from around the world. Out of 1,548 patients worldwide, 27% experienced at least one adverse event; 5.4% experienced multi-organ irAEs. Skin, laboratory, endocrine, neurologic and pulmonary abnormalities represented the most common organ systems involved.

Among the 84 cases with multi-organ irAEs, 70 patients (83.3%) had two organ systems affected, 13 (15.5%) had three, and one patient had four systems affected. 86% of multi-organ irAE patients experienced these side-effects sequentially rather than concurrently. According to the results, multi-organ irAEs were generally amenable to satisfactory management, and their occurrence was associated with better overall survival rates.

"Based on the mechanisms of action for these immune checkpoint agents, tumor response and irAEs are likely to have a common pathophysiology," said Dr. Kichenadasse. "There is also probably a cumulative immune activation with every dose of immunotherapy, meaning lengthier treatment could lead to both better survival and added organ damage. However, it is important to highlight that this analysis was exploratory and hypothesis generating; these results need to be confirmed through additional research."

"This study confirms that more than one organ, at the same time or sequentially, can be affected by immune-related adverse events from checkpoint inhibitor therapy," commented Igor Puzanov, MD, MSci, FACP, Professor of Medicine, Director of the Early Phase Clinical Trials Program and Chief of Melanoma at Roswell Park Comprehensive Cancer Center, who was not involved in this study. "This is worth noting for all practicing oncologists and other specialists taking care of patients who are receiving these therapies. The silver lining here is the seemingly improved overall survival we see among these patients."
To read the entire study and a related commentary, visit Complimentary access to "Multiorgan Immune-Related Adverse Events During Treatment With Atezolizumab" and "Immune Related Adverse Events: Implications for Immune Checkpoint Inhibitor Therapy" is available until December 10, 2020.

JNCCN Impact Factor Reaches New Record

The impact factor for JNCCN has risen from 7.570 to 9.316. It now ranks 21 out of 244 oncology journals measured, and in the top quartile for all medical journals worldwide. According to Clarivate Analytics, research published in JNCCN was cited a total of 2,534 times in 2017 and 2018.

About JNCCN--Journal of the National Comprehensive Cancer Network

More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN--Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about innovation in translational medicine, and scientific studies related to oncology health services research, including quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside. Visit To inquire if you are eligible for a FREE subscription to JNCCN, visit Follow JNCCN on Twitter @JNCCN.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, efficient, and accessible cancer care so patients can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit for more information and follow NCCN on Facebook @NCCNorg, Instagram @NCCNorg, and Twitter @NCCN.

National Comprehensive Cancer Network

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to