Impact of center volume on outcomes of adverse events after immune checkpoint inhibitors for cancer

Immune checkpoint inhibitors (ICIs) have improved oncologic outcomes of patients with various types of cancer, but also are associated with an increased risk of adverse events (AEs). Systematic review and meta-analysis of 147 studies of ICIs for solid organ malignancies found a pooled events rate (PER) of grade 5, grade 3-4, and any-grade AEs of 2.75% (95% CI 2.18-3.47), 26.69% (21.60-32.48), and 77.80% (70.91-83.44), respectively. A higher number of annual cases per center was significantly associated with reduced grade 5 (p=0.019), grade 3-4 (p=0.004), and cardiac-related AEs (p=0.035) in meta-regression. The authors conclude that these data demonstrate the importance of center volume in improving outcomes and reducing the incidence of severe AEs among patients receiving ICIs for solid organ malignancies.