Table 1.
Patient demographics, disease, treatment characteristics, and admission characteristics.
| Patient characteristics | No. (%; N = 102) |
|---|---|
| Male | 58 (56.9) |
| Median age (range) years | 68.5 (45-89) |
| Smoking status | |
| Current/former | 94 (92.2) |
| Never | 8 (7.8) |
| Histologic features | |
| Adenocarcinoma | 75 (73.5) |
| Squamous cell carcinoma | 20 (19.6) |
| Small cell lung cancer | 7 (6.9) |
| ECOG | |
| 0-1 | 79 (77.5) |
| ≥2 | 20 (19.6) |
| Unknown | 3 (2.9) |
| Baseline autoimmune disease | 23 (22.5) |
| Endocrinopathy∞ | 13 (12.7) |
| Inflammatory bowel disease | 2 (2.0) |
| Rheumatoid arthritis | 3 (2.9) |
| Psoriasis without arthritis | 4 (3.9) |
| Scleroderma (cutaneous involvement only) | 1 (1%) |
| Baseline immunosuppression | 9 (8.8) |
| Steroids | 8 (7.8) |
| -Prednisone <10 mg (or equivalent) | 2 (2.0) |
| -Prednisone ≥10 mg (or equivalent) | 6 (5.9) |
| Vedolizumab | 1 (1.0) |
| Pulmonary factors | |
| Underlying COPD | 28 (27.5) |
| Supplementary oxygen at baseline | 7 (6.9) |
| Prior thoracic radiation | 46 (45.1) |
| Treatment type at time of admission | |
| PD-1/PD-L1 inhibitor monotherapy | 60 (58.8) |
| Chemotherapy + PD-1/PD-L1 inhibitor | 33 (32.4) |
| PD-1/PD-L1 inhibitor plus CTLA-4 inhibitor | 7 (6.9) |
| Investigational ICI | 1 (1) |
| ICI + investigational agent | 1 (1) |
| Line of therapy | |
| Adjuvant | 9 (8.8) |
| First-line metastatic | 50 (49.0) |
| Second-line metastatic | 23 (22.5) |
| Third-line or beyond metastatic | 20 (19.6) |
| Duration of ICI prior to admission in days | |
| Median (range) | 64 (1-935) |
| Toxicity prompting admission | |
| Pneumonitis | 33 (32.4) |
| Gastrointestinal* | 21 (20.6) |
| Hepatitis | 13 (12.7) |
| Endocrinopathy** | 10 (9.8) |
| Myocarditis/pericarditisΩ | 10 (9.8) |
| Myositis | 5 (4.9) |
| Autoimmune hemolytic anemia | 3 (2.9) |
| Neurotoxicity$ | 3 (2.9) |
| ICI-arthritis | 2 (2.0) |
| Nephritis | 2 (2.0) |
| Treatment of toxicity | |
| Steroids | 87 (85.2) |
| 2L immunosuppression | 18 (17.6) |
| Disposition after discharge | |
| Home | 68 (66.7) |
| Rehab/skilled nursing facility | 10 (9.8) |
| With hospice services | 7 (6.9) |
| Hospitalization length | Days |
| Median (range) | 7 (2-28) |
| Received subsequent cancer therapy | |
| Yes (ICI and non-ICI) | 50 (49) |
| Received subsequent ICI | 21 |
| Delayed after admission only | 7 (6.9%) |
| Discontinued and resumed | 14 (13.7) |
| Alive at time of discharge | |
| Yes | 91 (89.2) |
| No | 11 (10.8) |
∞Endocrinopathy: hypothyroidism (n = 12), adrenal insufficiency (n = 1).
“Others: psoriasis without arthritis (n = 4), scleroderma (n = 1).
*Gastrointestinal (gastritis, esophagitis, enteritis, colitis, and pancreatitis).
$Neurotoxicity (transverse myelitis, peripheral neuropathy, and encephalitis).
**Endocrinopathy (diabetes n = 4, hypophysitis n = 1, thyroiditis n = 1, adrenal insufficiency n = 4).
Ω78.6% (11/14) of cases presenting with myocarditis were found to have a concomitant irAE, most frequently myositis and/or myasthenia gravis (35.7%; 5/14).
Investigational agent: mRNA vaccine.