Pancreatic adverse events induced by immune checkpoint inhibitors: a real-world observational study

Immune checkpoint inhibitor (ICI)-induced pancreatic adverse events (AEs) are rare occurrences that are poorly documented in the literature. We conducted a retrospective review of patients who had ICI up to June 2023. Patient follow-up was extended until death or to May 2024. The primary outcome was the incidence of severe ICI-related pancreatic AEs. Logistic regression was used to investigate the associations between clinical characteristics and severe ICI-related pancreatic AEs. The study included 7,840 participants who received ICI. The study population was predominantly male (74.50%), with a median age of 59.20 years [IQR 51.90–67.70 years]. Among them, 49 patients (0.63%) developed severe ICI-related pancreatic AEs. Logistic regression revealed that pancreatic cancer (OR 5.47; [95% CI, 1.12–26.82], <i>p</i> = 0.036), lung cancer (OR 2.62; [95% CI, 1.09–6.34], <i>p</i> = 0.032), younger patients (OR 0.97; [95% CI, 0.94–0.99], <i>p</i> = 0.015), and using PD-L1 inhibitor (OR 3.09, [95% CI 1.46 to 6.52], <i>p</i> = 0.003) were associated with a higher risk of severe ICI-related pancreatic AEs. This study demonstrated that most ICI-related pancreatic AEs were asymptomatic. Primary tumor type, age, and ICI type may be predictive factors for severe ICI-related pancreatic AEs. https://www.chictr.org.cn identifier is ChiCTR2300075974.