Background: Immune checkpoint inhibitors (ICIs) have revolutionised cancer therapy, yet they carry a unique spectrum of immune-related adverse events (irAEs). Given the ageing global population and the underrepresentation of older adults in clinical trials for ICIs, we investigated the occurrence and characteristics of irAEs in older versus younger adults as well as among different age subsets within the older adult population. Methods: We analysed the U.S. Food and Drug Administration Adverse Event Reporting System database reports from 2015 to 2023, focusing on ICIs. We categorised irAEs into 11 distinct types and performed descriptive and multivariate analyses to compare the prevalence and clinical characteristics of irAEs across different age groups, adjusting for potential confounding factors. Results: Among 47 513 patients aged 18–100 reporting irAEs, the 65–74 and 75–84 age groups had significantly increased risks compared to 18–64 (OR 1.13, 95% CI [1.09–1.18]; 1.15 [1.1–1.21]). Cardiovascular irAEs rose with age, peaking at 75–84, while endocrine irAEs decreased. Hepatobiliary, gastrointestinal and ocular irAEs decreased with age, but renal and musculoskeletal irAEs increased, showing higher risks in older adults. Serious outcomes slightly decreased in the 85+ group, while the proportion of deaths increased with age. Conclusion: We discuss the potential changes in the immune system contributing to the decreased prevalence of irAEs in the oldest age group. Additionally, conservative treatment approaches and underreporting of irAEs in older patients may influence these findings. Our findings highlight the need for personalised decision-making for ICI therapies, considering performance status and comorbidities rather than age alone.

This study aims to investigate the adverse effects of immune checkpoint inhibitors (ICIs) on the female and male reproductive systems. In the FDA Adverse Event Reporting System (FAERS) database, adverse reactions under the “Reproductive system and breast disorders” category in the System Organ Classes were included, covering a period from January 1, 2015, to June 30, 2023. We identified 133,512 patients treated with ICIs. Immune checkpoint inhibitor-related reproductive adverse effects (irRAEs) were reported in 568 (0.43%) patients. Spermatogenesis abnormality (ROR025 = 7.91) had the highest signal strength associated with ICI use in males. Genital tract fistula was the only significant irRAE (ROR025 = 2.72) in females. PD-1 inhibitors pose greater risk than CTLA-4 inhibitors (OR = 1.65 [1.05–2.79], p = 0.045). Gynecologic cancers in females (OR = 3.77 [2.82–4.99], p < 0.0001) and urogenital cancers in males (OR = 1.56 [1.17–2.06], p = 0.0018) carried the highest risk compared to other cancers. Additional targeted drugs (OR = 2.32 [1.76–3.02], p < 0.0001), particularly lenvatinib (OR = 3.50 [2.48–4.94], p < 0.0001) and cabozantinib (OR = 3.71 [1.96–7.03], p < 0.0001) significantly increased the risk for females. Additional use of chemotherapy drugs was associated with a significant reduction in the risk for males (OR = 0.65 [0.42–0.96], p = 0.042) except for doxorubicin (OR = 2.58 [1.22–5.47], p = 0.013) and cyclophosphamide (OR = 2.36 [1.05–5.29], p = 0.038). This study demonstrates that ICIs could potentially lead to a wide range of adverse effects in the reproductive system in both males and females.

Immune checkpoint inhibitors (ICIs) therapy has revolutionized cancer treatment. However, it is important to acknowledge that ICI therapy can lead to immune-related adverse events (irAEs), including myocarditis. While early-onset myocarditis is well-documented, late-onset cases are increasingly recognized. This case series presents four cases of late-onset ICI-associated myocarditis, emphasizing the need for long-term surveillance of this potentially fatal complication. Patients exhibited a range of cardiac symptoms, including chest pain, shortness of breath, and arrhythmias. The diagnosis was confirmed through cardiac magnetic resonance imaging (MRI) and elevated cardiac biomarkers. Treatment involved the immediate discontinuation of ICI therapy and the initiation of high-dose corticosteroids. In cases with an inadequate response, additional immunosuppressive agents were considered. This case series underscores the importance of prolonged monitoring for late-onset ICI-associated myocarditis. Further research is needed to establish optimal treatment strategies and long-term management approaches for this complex condition.

Pazopanib is an oral multi-kinase inhibitor approved for the treatment of advanced renal cell carcinoma (RCC). It is an anti-angiogenic agent, which blocks the activation signaling pathways of tyrosine kinases and prevents the activities of primarily vascular endothelial growth factor receptors (VEGFR)-2 and VEGFR-3, which are important in lymphangiogenesis. Herein, we report a patient with advanced RCC who developed asymptomatic left-sided chylothorax under pazopanib therapy. Chylothorax developed in the 16th month and gradually increased until it was diagnosed by thoracentesis in the 22nd month. The development of chylothorax was attributed to pazopanib therapy after ruling out all possible traumatic and nontraumatic etiologies. The ‘Adverse Drug Reaction Probability Scale’ revealed a total score of 6, which fell into ‘probable’ category. Chylothorax regressed significantly 5 weeks after the discontinuation of pazopanib therapy.

Aim: Alterations in plasma lipid levels have been shown to be correlated with the severity of infections due to various pathogens such as bacteria, viruses. In this study, we aimed to evaluate the lipid metabolism changes associated with disease severity and prognosis in hospitalized COVID-19 patients during and after (post-COVID) the disease. Material and Method: Patients who were hospitalized in the COVID-19 wards between April 02, 2020, and November 20, 2020 and were then evaluated in the follow-up outpatient clinic were retrospectively searched. Results: Lipid levels were present at the admission and follow-up for 95 patients. The mean (S.D) age was 48.49 (16.4), and 49(51.6%) were male. The mean (S.D) day between the admission and the first visit in the COVID-19 follow-up outpatient clinic was 27.8 (12.8). LDL-C (p=0.044), and HDL-C (p=0.004) levels were significantly lower in the severely ill group at the admission. Total cholesterol, LDL-C, HDL-C, and triglyceride levels on follow-up were significantly higher than those levels on the admission day (p