Abstract 914: Racial disparities in immune-related adverse events with immune checkpoint inhibitors: A systematic review and meta-analysis.

Abstract Background: There is insufficient data on whether immune-related adverse events (irAEs) from immune checkpoint inhibitors (ICIs) differ by race/ethnicity. The objective of our study was to systematically evaluate the incidence of irAEs by race to inform equitable treatment approaches. Methods: We searched PubMed/MEDLINE and Embase from inception through December 16, 2024 for randomized trials and cohort studies in adults receiving ICIs. Race-specific incidence was pooled using a generalized linear mixed-effects proportional meta-analysis. Within-study odds ratios (ORs) versus White were pooled with random-effects inverse-variance models; heterogeneity was summarized with I2 and inspected with leave-one-out analyses. Subgroup analyses were conducted based on ICI class (PD-1 monotherapy and dual PD-1/CTLA-4 therapy), tumor type (lung cancer), and study design (excluding organ-specific irAE reports and excluding registry-based database studies). Results: Of the 3,397 records screened, 510 full-text articles were assessed for eligibility, and 24 studies comprising 109,902 patients were included in the analysis. In the overall population, the pooled incidence of irAEs was 13.7% (95% CI, 2.7-47.5) in Asian, 20.6% (8.6-41.7) in Black, 16.0% (5.1-40.5) in Hispanic, and 20.5% (11.1-34.8) in White patients, with substantial heterogeneity (I2=85.7-99.8%). Pooled ORs versus White were not statistically significant: non-White 1.28 (95% CI 0.82-1.98), Asian 1.67 (0.76-3.70), Black 1.37 (0.83-2.27), and Hispanic 0.89 (0.55-1.42); all p0.05. Findings showed a consistent trend across the ICI-class subgroups, the lung-cancer subgroup, and the subgroup excluding registry-based studies. Conclusion: No significant differences in irAEs were observed among races. These findings support equitable access to ICI therapy and culturally competent toxicity monitoring. Citation Format: Toshiaki Takahashi, Yu Fujiwara, Ahmad Bouhuwaish, Kohei Chida, Rodrigo Paredes, Sarbajit Mukherjee. Racial disparities in immune-related adverse events with immune checkpoint inhibitors: A systematic review and meta-analysis abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 914.