skip to main content

irAE Efficacy Correlation — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateImmunotherapy & Targeted TherapyirAE Efficacy CorrelationSCE Medical Oncology

A 62-year-old man with metastatic melanoma on nivolumab develops immune-related vitiligo and grade 1 hypothyroidism (managed with levothyroxine). He has had an excellent tumour response (near-complete response). He asks whether having multiple irAEs is a good sign. What does the evidence suggest?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Multi-organ irAE development is associated with improved tumour response and survival outcomes in multiple cancer types — it reflects robust immune activation

Multiple independent meta-analyses and large retrospective studies have demonstrated a consistent association between irAE development and improved tumour response, PFS and OS across multiple cancer types (melanoma, NSCLC, RCC). Multi-organ irAEs correlate more strongly with benefit than single-organ events. This 'irAE-efficacy correlation' reflects the shared immune activation underlying both anti-tumour immunity and autoimmunity. However, severe irAEs requiring immunosuppression may partially offset this benefit. This association should not discourage appropriate irAE management.

Reference: ESMO 2024 irAE and Efficacy Guidelines; Shankar et al Lancet Oncol 2022; Das et al JCO 2019