# Patient-Reported Burden and Clinical Spectrum of Rheumatic Immune-Related Adverse Events After Immune Checkpoint Inhibitor Therapy in Lung Cancer: A Real-World Cohort Study

Article · Ren Z, Lu J

- Archive id: doi:10.3390/curroncol33100603
- Published: 2026-10-07
- Venue: Current oncology (Toronto, Ont.)
- DOI: https://doi.org/10.3390/curroncol33100603
- PMID: 42930170
- PMCID: PMC13703647
- Citations: 0
- Source URL: https://doi.org/10.3390/curroncol33100603
- PDF: https://europepmc.org/articles/PMC13703647/pdf
- Provenance: europepmc

## Abstract

Background Rheumatic immune-related adverse events (R-irAEs) after immune checkpoint inhibitor (ICI) therapy in lung cancer can be difficult to distinguish from cancer-related or degenerative musculoskeletal symptoms. Methods In this single-center retrospective cohort, we analyzed 768 ICI-treated patients and a nested questionnaire cohort to characterize rheumatologist-confirmed R-irAEs, baseline associated factors, and patient-reported outcomes. Missing baseline C-reactive protein (CRP) was handled using multiple imputation. Results New musculoskeletal symptoms occurred in 177 patients (23.0%), and 66 patients (8.6%) had confirmed R-irAEs. The leading phenotypes were inflammatory arthritis ( n = 22), inflammatory arthralgia ( n = 15), and polymyalgia rheumatica-like syndrome ( n = 13). In multivariable analysis, female sex (adjusted odds ratio \[OR\] 2.21, 95% confidence interval \[CI\] 1.31-3.74), baseline CRP \> 10 mg/L (OR 2.08, 95% CI 1.14-3.81), and pre-existing autoimmune disease (OR 5.24, 95% CI 2.37-11.57) were associated with confirmed R-irAEs. Among 437 questionnaire responders, confirmed R-irAEs were associated with worse pain, morning stiffness, disability, fatigue, and health status than non-confirmed musculoskeletal symptoms (all Holm-adjusted p \< 0.001). Conclusions Confirmed R-irAEs affected a measurable minority of ICI-treated patients with lung cancer and were associated with worse post-treatment patient-reported outcomes. Because baseline patient-reported outcomes were unavailable, these findings should not be interpreted as R-irAE-attributable change.

_Abstract reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [Cancer Immunotherapy](https://space-kitty.com/topics/cancer-immunotherapy)

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