C-reactive protein as an early marker of immune-related adverse events.
Adverse events
C-reactive protein
Immune checkpoint inhibitors
Melanoma
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
08
07
2019
accepted:
09
08
2019
pubmed:
8
9
2019
medline:
8
10
2019
entrez:
8
9
2019
Statut:
ppublish
Résumé
Immune checkpoint inhibitors (ICIs) are effective against a wide variety of cancers. However, they also induce a plethora of unique immune-related adverse events (irAEs). Since for many organ systems symptoms can be unspecific, differential diagnosis with progression of disease or infection may be difficult. C-reactive protein (CRP) has been suggested as a marker for infection. The purpose of this study was to evaluate the diagnostic value of CRP in differentiating infectious causes from autoimmune side effects induced by ICIs. In order to investigate the role of CRP in irAEs, we screened our patient data base. Only events with full infectious workup were included. In total 88 events of irAEs in 37 melanoma patients were analyzed. CRP levels before and during irAEs were evaluated. Statistical analyses were conducted using the Chi-square test for categorical variables. At the onset of irAE, CRP rose in 93% of cases to a mean of 52.7 mg/L (CI 35.1-70.3) from 8.4 mg/L at baseline (normal < 5 mg/L) (P < 0.0001). Other causes of CRP elevation including infectious diseases were excluded, and procalcitonin (PCT) levels were normal in 92% of events. Importantly, in 42% of cases CRP elevations preceded clinical symptoms. CRP elevation can predict the onset of irAEs in patients treated with ICIs in the absence of infectious disease.
Identifiants
pubmed: 31492984
doi: 10.1007/s00432-019-03002-1
pii: 10.1007/s00432-019-03002-1
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
Biomarkers
0
Biomarkers, Tumor
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2625-2631Références
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