Evidence map›Paper›PMID 37195459›Full record

ArticleJournal of the National Cancer Institute2023

Early mortality in patients with cancer treated with immune checkpoint inhibitors in routine practice.

Jacques Raphael, Lucie Richard, Melody Lam, Phillip Blanchette, Natasha B Leighl, George Rodrigues, Maureen Trudeau, Monika K Krzyzanowska

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Early Detriment Analysis of First-Line Nivolumab plus Ipilimumab-Based Therapy in Patients with Metastatic Non-Small Cell Lung Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
    Trial
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jacques RaphaelDivision of Medical Oncology, Department of Oncology, London Regional Cancer Program, University of Western Ontario, London, ON, Canada.ORCID 0000-0002-9484-0224
Lucie RichardICES Western, London, ON, Canada.
Melody LamICES Western, London, ON, Canada.
Phillip BlanchetteDivision of Medical Oncology, Department of Oncology, London Regional Cancer Program, University of Western Ontario, London, ON, Canada.
Natasha B LeighlDivision of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, ON, Canada.
George RodriguesDivision of Radiation Oncology, Department of Oncology, London Regional Cancer Program, University of Western Ontario, London, ON, Canada.
Maureen TrudeauDivision of Medical Oncology, Department of Medicine, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada.
Monika K KrzyzanowskaDivision of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe sought to estimate the proportion of patients with cancer treated with immune checkpoint inhibitors (ICI) who die soon after starting ICI in the real world and examine factors associated with early mortality (EM).

methodsWe conducted a retrospective cohort study using linked health administrative data from Ontario, Canada. EM was defined as death from any cause within 60 days of ICI initiation. Patients with melanoma, lung, bladder, head and neck, or kidney cancer treated with ICI between 2012 and 2020 were included.

resultsA total of 7126 patients treated with ICI were evaluated. Fifteen percent (1075 of 7126) died within 60 days of initiating ICI. The highest mortality was observed in patients with bladder and head and neck tumors (approximately 21% each). In multivariable analysis, previous hospital admission or emergency department visit, prior chemotherapy or radiation therapy, stage 4 disease at diagnosis, lower hemoglobin, higher white blood cell count, and higher symptom burden were associated with higher risk of EM. Conversely, patients with lung and kidney cancer (compared with melanoma), lower neutrophil to lymphocytes ratio, and with higher body mass index were less likely to die within 60 days post ICI initiation. In a sensitivity analysis, 30-day and 90-day mortality were 7% (519 of 7126) and 22% (1582 of 7126), respectively, with comparable clinical factors associated with EM identified.

conclusionsEM is common among patients treated with ICI in the real-world setting and is associated with several patient and tumor characteristics. Development of a validated tool to predict EM may facilitate better patient selection for treatment with ICI in routine practice.

Indexed as

Carcinoma, Renal CellKidney NeoplasmsLung NeoplasmsMelanomaHumansImmune Checkpoint InhibitorsOntarioRetrospective StudiesImmune Checkpoint Inhibitors

Identifiers

PMID37195459
PMCPMC10407698

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.