Exploring tumor lysis syndrome linked to immune checkpoint inhibitors: insights from the FAERS pharmacovigilance database.

Publication date: Jul 02, 2025

The increasing use of immune checkpoint inhibitors (ICIs) has raised concerns about immune-related adverse events (irAEs), including tumor lysis syndrome(TLS), traditionally linked to cytotoxic chemotherapy. This study investigates the association between ICIs and TLS, analyzing clinical characteristics, treatment regimens, and outcomes. ICIs-associated TLS cases reported in the FDA Adverse Event Reporting System (FAERS) from Q1 2011 to Q1 2024 were analyzed. Disproportionality analysis and Weibull shape parameter (WSP) modeling were used to assess reporting trends and onset patterns. Among 364 TLS cases, anti-PD-1 were most frequently implicated (n = 210), followed by anti-PD-L1 (n = 109) and anti-CTLA-4 (n = 45). Combination therapies accounted for 61. 0% of cases, with distinct disease distributions: dual ICIs in melanoma (36. 36%), ICIs plus chemotherapy in lung cancer (47. 37%), and ICIs plus antiangiogenic therapy in hepatocellular carcinoma (59. 14%). The median onset time was 9 days (IQR: 3-23. 75), with WSP analysis indicating an early failure pattern (β = 0. 75, 95% CI: 0. 66-0. 85). ICIs are significantly associated with TLS, particularly in combination regimens, necessitating early risk identification and close monitoring. Given the rising use of ICIs, proactive management and ongoing pharmacovigilance are essential to mitigate severe outcomes.

Concepts Keywords
9days disproportionality analysis
Chemotherapy Pharmacovigilance
Fda Weibull distribution analysis
Iqr
Pharmacovigilance

Semantics

Type Source Name
disease MESH tumor lysis syndrome
disease MESH melanoma
pathway KEGG Melanoma
disease MESH lung cancer
disease MESH hepatocellular carcinoma
pathway KEGG Hepatocellular carcinoma

Original Article

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