Patient-Reported Burden and Clinical Spectrum of Rheumatic Immune-Related Adverse Events After Immune Checkpoint Inhibitor Therapy in Lung Cancer: A Real-World Cohort Study.
- 1Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Chengdu 610041, China.
- 2Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Chengdu 610041, China.
Abstract
Background
Rheumatic immune-related adverse events (R-irAEs) after immune checkpoint inhibitor (ICI) therapy in lung cancer can be difficult to distinguish from cancer-related or degenerative musculoskeletal symptoms.Methods
In this single-center retrospective cohort, we analyzed 768 ICI-treated patients and a nested questionnaire cohort to characterize rheumatologist-confirmed R-irAEs, baseline associated factors, and patient-reported outcomes. Missing baseline C-reactive protein (CRP) was handled using multiple imputation.Results
New musculoskeletal symptoms occurred in 177 patients (23.0%), and 66 patients (8.6%) had confirmed R-irAEs. The leading phenotypes were inflammatory arthritis (n = 22), inflammatory arthralgia (n = 15), and polymyalgia rheumatica-like syndrome (n = 13). In multivariable analysis, female sex (adjusted odds ratio [OR] 2.21, 95% confidence interval [CI] 1.31-3.74), baseline CRP > 10 mg/L (OR 2.08, 95% CI 1.14-3.81), and pre-existing autoimmune disease (OR 5.24, 95% CI 2.37-11.57) were associated with confirmed R-irAEs. Among 437 questionnaire responders, confirmed R-irAEs were associated with worse pain, morning stiffness, disability, fatigue, and health status than non-confirmed musculoskeletal symptoms (all Holm-adjusted p < 0.001).Conclusions
Confirmed R-irAEs affected a measurable minority of ICI-treated patients with lung cancer and were associated with worse post-treatment patient-reported outcomes. Because baseline patient-reported outcomes were unavailable, these findings should not be interpreted as R-irAE-attributable change.
Related
- Patients with Cancer and Immune Checkpoint Inhibitor-Induced Rheumatic irAEs Treated by DMARDs: The RHUMICI Single-Centre Retrospective Cohort
- Clinical, Radiologic, and Highest-Grade Assessment of Immune Checkpoint Inhibitor Pneumonitis in Non–Small Cell Lung Cancer
- Preclinical-Clinical Discrepancies in Immune Checkpoint Inhibitor Efficacy for Triple-Negative Breast Cancer: Disease Stage, Antibody Properties, Biomarker Alignment, and Model Limitations.
- Clinical outcomes of near-infrared photoimmunotherapy according to immune checkpoint inhibitor timing and treatment sequence: a multicenter retrospective study
- Clinical characteristics and pharmacovigilance signals of immune checkpoint inhibitor-associated cystitis and ureteritis: analysis of FAERS reports and published cases
BibTeX
@article{ren2026patientreported,
title = {{Patient-Reported Burden and Clinical Spectrum of Rheumatic Immune-Related Adverse Events After Immune Checkpoint Inhibitor Therapy in Lung Cancer: A Real-World Cohort Study.}},
author = {Zhenhong Ren and Jianchao Lu},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = oct,
doi = {10.3390/curroncol33100603},
url = {https://europepmc.org/article/MED/42930170},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient-Reported Burden and Clinical Spectrum of Rheumatic Immune-Related Adverse Events After Immune Checkpoint Inhibitor Therapy in Lung Cancer: A Real-World Cohort Study.
AU - Zhenhong Ren
AU - Jianchao Lu
PY - 2026
DA - 2026/10/07
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100603
UR - https://europepmc.org/article/MED/42930170
AB - Background Rheumatic immune-related adverse events (R-irAEs) after immune checkpoint inhibitor (ICI) therapy in lung cancer can be difficult to distinguish from cancer-related or degenerative musculoskeletal symptoms.Methods In this single-center retrospective cohort, we analyzed 768 ICI-treated patients and a nested questionnaire cohort to characterize rheumatologist-confirmed R-irAEs, baseline associated factors, and patient-reported outcomes. Missing baseline C-reactive protein (CRP) was handled using multiple imputation.Results New musculoskeletal symptoms occurred in 177 patients (23.0%), and 66 patients (8.6%) had confirmed R-irAEs. The leading phenotypes were inflammatory arthritis (n = 22), inflammatory arthralgia (n = 15), and polymyalgia rheumatica-like syndrome (n = 13). In multivariable analysis, female sex (adjusted odds ratio [OR] 2.21, 95% confidence interval [CI] 1.31-3.74), baseline CRP > 10 mg/L (OR 2.08, 95% CI 1.14-3.81), and pre-existing autoimmune disease (OR 5.24, 95% CI 2.37-11.57) were associated with confirmed R-irAEs. Among 437 questionnaire responders, confirmed R-irAEs were associated with worse pain, morning stiffness, disability, fatigue, and health status than non-confirmed musculoskeletal symptoms (all Holm-adjusted p < 0.001).Conclusions Confirmed R-irAEs affected a measurable minority of ICI-treated patients with lung cancer and were associated with worse post-treatment patient-reported outcomes. Because baseline patient-reported outcomes were unavailable, these findings should not be interpreted as R-irAE-attributable change.
SN - 1198-0052
SN - 1718-7729
ER -