Observational studyJournal for immunotherapy of cancer2026
Extracorporeal photopheresis versus systemic immunosuppression for treatment of immune-related adverse events: clinical outcomes from the prospective two-arm PRIA study.
Observational study in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05700565 (Treatment of Immune-related Adverse Events Refractory to Standard Therapy and Associated Changes in Immunophenotype), which is not on this map. Not yet cited in PubMed.
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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.
The trial behind it
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Treatment of Immune-related Adverse Events Refractory to Standard Therapy and Associated Changes in Immunophenotype
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmune checkpoint inhibitor-induced immune-related adverse events (irAEs) can be steroid-refractory (sr) or steroid-dependent (sd), requiring second-line therapy. Evidence guiding optimal management of sr/sd-irAEs while preserving antitumor efficacy is scarce. This study compared extracorporeal photopheresis (ECP) with systemic immunosuppressants (IS) for treatment of sr/sd-irAEs.
methodsThis prospective two-arm study included 46 patients (23 ECP, 23 IS) with 12 distinct types of irAEs across 6 tumor entities, all classified as steroid-refractory or steroid-dependent. Toxicities affected the gastrointestinal tract, skin, lung, musculoskeletal system, and serosal membranes, with up to seven prior irAE treatment lines. Patients received six cycles of ECP or investigator's choice IS over 12 weeks. Longitudinal assessments included clinical irAE outcomes, quality of life (QoL), and tumor response. ECP was more frequently used in patients with multi-toxicity (39% vs 9%; p=0.02) and multi-resistance to prior second-line immunosuppression (39% vs 17%; p=0.19).
resultsAt week 12, ECP showed a lower cumulative corticosteroid exposure (395 mg vs 1,260 mg prednisolone equivalent; p=0.03), significantly improved QoL (p=0.01), and a numerically higher irAE response rate without statistical significance compared with IS (94% vs 81%; p=0.85). In advanced cutaneous melanoma, ECP was associated with superior overall survival (15 vs 10 months; p=0.02), and longer progression-free survival (9 vs 3 months; p=0.01). No significant safety concerns were observed with ECP; one fatality in the IS group was infection-related.
conclusionsECP demonstrated clinical outcomes comparable to IS in sr/sd-irAEs, with significantly lower cumulative corticosteroid exposure and improved QoL. Furthermore, ECP was associated with a favorable safety profile and showed no evidence of compromised antitumor activity. A multicenter trial is planned for further investigation. TRIAL REGISTRATION NUMBER: NCT05700565.
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