{"doi":"10.1101/2023.01.16.23284635","title":"Cutaneous immune-related adverse events are associated with longer overall survival in advanced cancer patients on immune checkpoint inhibitors: a multi-institutional cohort study","abstract":"Background: Cutaneous immune-related adverse events (cirAEs) occur in up to 40% of immune checkpoint inhibitor (ICI) recipients. However, the association of cirAEs with survival remains unclear. Objective: To investigate the association of cirAEs with survival among ICI recipients. Methods: ICI recipients were identified from the Mass General Brigham healthcare system (MGB) and Dana-Farber Cancer Institute (DFCI). Patient charts were reviewed for cirAE development within 2 years after ICI initiation. Multivariate time-varying Cox proportional hazards models, adjusted for age, sex, race/ethnicity, Charlson Comorbidity Index, ICI type, cancer type, and year of ICI initiation were utilized to investigate the impact of cirAE development on overall survival. Results: Of the 3,731 ICI recipients, 18.1% developed a cirAE. 6-month landmark analysis and time-varying Cox proportional hazards models demonstrated that patients who developed cirAEs were associated with decreased mortality (HR=0.87,p=0.027), particularly in melanoma patients (HR=0.67,p=0.003). Among individual morphologies, lichenoid eruption (HR=0.51,p<0.001), psoriasiform eruption (HR=0.52,p=0.005), vitiligo (HR=0.29,p=0.007), isolated pruritus without visible manifestation of rash (HR=0.71,p=0.007), acneiform eruption (HR =0.34,p=0.025), and non-specific rash (HR=0.68, p<0.001) were significantly associated with better survival after multiple comparisons adjustment. Limitations: Retrospective design; single geography. Conclusion: CirAE development is associated with improved survival among ICI recipients, especially melanoma patients. Capsule Summary: Patients on immune checkpoint inhibitors (ICIs) who developed cutaneous immune-related adverse events (cirAEs) had favorable outcomes. This was especially notable for melanoma patients who had cirAEs, both those with vitiligo and other morphologies.Development of cirAEs in ICI-treated patients can be used to prognosticate survival and guide treatment decisions.","journal":"medRxiv","year":2023,"id":391624,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9078,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":865735,"name":"Kimberly Tang","orcid":"0000-0002-7718-2872","position":1,"is_corresponding":false},{"id":865732,"name":"Guihong Wan","orcid":"0000-0003-1100-4018","position":2,"is_corresponding":false},{"id":865733,"name":"Nga Nguyen","orcid":"0000-0003-2935-3603","position":3,"is_corresponding":false},{"id":241918,"name":"Chenyue Lu","orcid":"0000-0002-7905-2078","position":4,"is_corresponding":false},{"id":1022617,"name":"Pearl Ugwu‐Dike","orcid":"0000-0002-8742-6930","position":5,"is_corresponding":false},{"id":1022618,"name":"Neel S. Raval","orcid":"0000-0001-6443-7883","position":6,"is_corresponding":false},{"id":1022619,"name":"Jayhyun Seo","orcid":"0000-0002-1599-113X","position":7,"is_corresponding":false},{"id":535323,"name":"Nora A. Alexander","orcid":"0000-0003-3011-1353","position":8,"is_corresponding":false},{"id":398138,"name":"Ruple Jairath","orcid":"0000-0002-1896-5295","position":9,"is_corresponding":false},{"id":865737,"name":"Jordan Phillipps","orcid":"0000-0002-9156-3567","position":10,"is_corresponding":false},{"id":865734,"name":"Bonnie W. Leung","orcid":"0000-0002-6627-1570","position":11,"is_corresponding":false},{"id":1023453,"name":"Kathleen Roster","orcid":null,"position":12,"is_corresponding":false},{"id":865739,"name":"Wenxin Chen","orcid":"0000-0002-5122-1933","position":13,"is_corresponding":false},{"id":105186,"name":"Leyre Zubiri","orcid":"0000-0003-4226-7443","position":14,"is_corresponding":false},{"id":411,"name":"Genevieve M. Boland","orcid":"0000-0002-7522-6173","position":15,"is_corresponding":false},{"id":105246,"name":"Steven T. Chen","orcid":"0000-0001-8844-3284","position":16,"is_corresponding":false},{"id":18038,"name":"Hensin Tsao","orcid":"0000-0002-2204-2071","position":17,"is_corresponding":false},{"id":441396,"name":"Shadmehr Demehri","orcid":"0000-0002-7913-2641","position":18,"is_corresponding":false},{"id":334800,"name":"Nicole R. LeBoeuf","orcid":"0000-0002-8264-834X","position":19,"is_corresponding":false},{"id":105169,"name":"Kerry L. Reynolds","orcid":"0000-0002-7793-654X","position":20,"is_corresponding":false},{"id":60417,"name":"Kun‐Hsing Yu","orcid":"0000-0001-9892-8218","position":21,"is_corresponding":false},{"id":6113,"name":"Alexander Gusev","orcid":"0000-0002-7980-4620","position":22,"is_corresponding":false},{"id":323965,"name":"Shawn G. Kwatra","orcid":"0000-0003-3736-1515","position":23,"is_corresponding":false},{"id":627967,"name":"Yevgeniy R. Semenov","orcid":"0000-0002-7387-3094","position":24,"is_corresponding":false},{"id":342327,"name":"Shijia Zhang","orcid":"0000-0001-6108-0321","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T01:18:47.408273Z","pmid":"36711758","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}