Clinical risk factors for polyneuropathy in patients receiving immune checkpoint inhibitor therapy.

Abstract

e24174 Background: This study investigates neurological toxicities, particularly polyneuropathy, as immune-related adverse events (irAEs) following immune checkpoint inhibitor (ICI) therapy, aiming to clarify clinical factors associated with polyneuropathy development. Methods: We analyzed participants who received ICIs in the All of Us Controlled Tier v8 dataset from December 2012 to September 2023. Variables included age, sex, race, alcohol consumption, smoking status, comorbid conditions including hypertension and diabetes mellitus, anticancer agents potentially associated with neuropathy, and individual ICI therapies. Associations were initially assessed using chi-square tests, and variables that demonstrated statistically significant associations in univariable analyses were subsequently included in multivariable logistic regression analyses. Results: Among 998 ICI-treated patients, 202 developed polyneuropathy, with an incidence of 20.2%. In unadjusted analyses, polyneuropathy was significantly associated with sex, hypertension, and exposure to platinum- and taxane-based chemotherapy (p < 0.05). In multivariable analyses, female sex (adjusted OR = 1.47, 95% CI 1.05–2.05), hypertension (adjusted OR = 1.62, 95% CI 1.13–2.34), and taxane-based chemotherapy exposure (adjusted OR = 1.71, 95% CI 1.14–2.59) remained independently associated with increased risk of polyneuropathy. Conclusions: Female sex, hypertension, and taxane-based chemotherapy exposure are independent risk factors for polyneuropathy in patients treated with ICIs. These findings highlight the need for proactive risk stratification and vigilant monitoring, particularly in female patients receiving concomitant taxane therapy.