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OpenTrials
Completed

NCT Number: NCT04898751

Analysis of Reporting of Cutaneous Toxicities Associated With Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICIs) are associated with a wide variety of cutaneous immune-related adverse events (cirAEs). These cirAEs are reported to be the most common immune-related adverse events (irAEs) and the first to appear. This study examines the appearance of cirAEs within the World Health Organization (WHO) pharmacovigilance database, VigiBase.

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Key information

Sex eligibility

All sexes

Study type

Observational

Primary location

Sidney Kimmel Comprehensive Care Center

Baltimore, Maryland, 21215, United States

About this study

ICIs have revolutionized clinical oncologic care. The ICIs that are currently FDA approved fall into three main categories: those that block the cytotoxic T-lymphocyte-associated antigen-4 (anti-CTLA-4; ipilimumab), block the programmed cell death protein-1 (anti-PD-1; nivolumab, pembrolizumab, cemiplimab), and block the programmed cell death ligand-1 (anti-PD-L1; atezolizumab, avelumab, durvalumab) pathway. There is a considerable diversity of cirAEs that have been reported with these ICIs in both monotherapy and combination therapy.

VigiBase is the WHO pharmacovigilance database that monitors individual case safety reports associated with certain drugs. The largest database of its kind in the world, VigiBase is managed by the Uppsala Monitoring Center (UMC) in Sweden, and since its inception in 1967 has received over 19 million individual case safety reports (ICSRs) from over 130 contributing countries. In this study, the investigators examine the appearance of cutaneous immune related adverse events in the setting of immunotherapy within VigiBase.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Treated with either Ipilimumab (L01XC11), Nivolumab (L01XC17), Pembrolizumab (L01XC18), Durvalumab (L01XC28), Avelumab (L01XC31), Atezolizumab (L01XC32), and Cemiplimab (L01XC33).
  • Developed an adverse reaction that was submitted to a pharmacovigilance center and was determined to be related to aforementioned immune checkpoint inhibitors.
  • Adverse reaction was determined to be within the System Organ Class (SOC) "Skin and subcutaneous disorder".

Exclusion criteria

  • Adverse event was determined not to be immune-related (for example, infectious etiology) or was a symptom (e.g., edema).
  • Adverse event developed before the administration of ICI.

Treatment and study plan

Immune checkpoint inhibitor (ICI)

Drug

Immune checkpoint inhibitors included were targeting either PD-1, PD-L1 or CTLA-4, and had received FDA approval at the time of study (ATC classification): Ipilimumab (L01XC11), Nivolumab (L01XC17), Pembrolizumab (L01XC18), Durvalumab (L01XC28), Avelumab (L01XC31), Atezolizumab (L01XC32), and Cemiplimab (L01XC33).

Other names: Ipilimumab (Yervoy, L01XC11), Nivolumab (Opdivo, L01XC17), Pembrolizumab (Keytruda, L01XC18), Durvalumab (Imfinzi, L01XC28), Avelumab (Bavencio, L01XC31), Atezolizumab (Tecentriq, L01XC32), Cemiplimab (Libtayo, L01XC33)

Primary outcomes

  1. Cutaneous toxicity of ICIs

    Time frame: From 01/01/2008 to 08/31/2020

    Number of reported adverse events associated with ICIs within the Systems Organ Class (SOC) "Skin and subcutaneous disorders" with one of the 7 FDA-approved ICIs Ipilimumab (L01XC11), Nivolumab (L01XC17), Pembrolizumab (L01XC18), Durvalumab (L01XC28), Avelumab (L01XC31), Atezolizumab (L01XC32), or Cemiplimab (L01XC33), alone or in any combination with each other.

Secondary outcomes

  1. Reporting odds ratio for monotherapy vs combination therapy

    Time frame: From 01/01/2008 to 08/31/2020

    Reporting odds ratio for appearance of cirAEs, comparing the odds of appearance of cirAEs with monotherapy with PD-1, PD-L1, or CTLA-4 against combination therapy with a PD-1/PD-L1 and CTLA-4 agent.

  2. Reporting odds ratio for differing monotherapy

    Time frame: From 01/01/2008 to 08/31/2020

    Reporting odds ratio for appearance of cirAEs comparing monotherapy with PD1 or PD-L1 against monotherapy with CTLA-4

  3. Co-occuring irAEs

    Time frame: From 01/01/2008 to 08/31/2020

    Prevalence (%) of co-occuring irAEs within other organ systems (GI, endocrine/metabolic, pulmonary, cardiac, renal, hematologic, neurologic, rheumatologic, and ophthalmologic) with cirAEs.

  4. Disproportionality assessment of cirAEs with ICIs

    Time frame: From 01/01/2008 to 08/31/2020

    Information component (IC), a Bayesian confidence neural network propagation method devised by the Uppsala Monitoring Center, will determine significant disproportionate signal of cirAEs associated with ICIs if >0 at the bottom of the 95% confidence interval (IC025 > 0).

  5. Indication

    Time frame: From 01/01/2008 to 08/31/2020

    Prevalence (%) of malignancy types (such as melanoma, pulmonary, and renal cell carcinoma) for patients receiving ICIs and developing cirAEs.

  6. Time to onset

    Time frame: From 01/01/2008 to 08/31/2020

    Time to onset of cirAEs after ICI administration, measured in days.

Sponsors and collaborators

Lead sponsor

Johns Hopkins University

Other

Registry information

Important dates

Study start
2008
Primary completion
2020
Study completion
2020
First posted
May 24, 2021
Registry last updated
May 24, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.