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Using the FAERS database (2015Q1\u20132024Q3), we conducted a large\u2010scale pharmacovigilance analysis to address the epidemiological and clinical knowledge gaps in ICI\u2010associated vitiligo. Of the 162,022 reported ICI\u2010related adverse events, 359 cases of vitiligo were identified (0.22%). Among these vitiligo cases, the three most common underlying malignancies were melanoma (59.4%), metastatic malignancies (28%, primarily metastatic melanoma and lung cancer), and lung cancer (6.8%). A disproportionality analysis utilizing reporting odds ratio (ROR), stratified by ICI class, cancer type, and patient characteristics, identified previously unreported associations between vitiligo and malignancies beyond melanoma. Generalized additive model (GAM) analysis demonstrated a significant non\u2010linear relationship between WT and both the risk and temporal development pattern of vitiligo. This study confirms vitiligo as a multi\u2010dimensional irAE with cross\u2010tumor prognostic value and reveals the modulating role of metabolic factors on its clinical presentation, providing crucial scientific evidence for optimizing risk stratification and personalized immunotherapy strategies.<\/jats:p>","DOI":"10.1002\/ijc.70159","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T16:01:27Z","timestamp":1758211287000},"page":"738-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Immune checkpoint inhibitor\u2010induced vitiligo: A large\u2010scale real world pharmacovigilance study"],"prefix":"10.1002","volume":"158","author":[{"given":"Bufu","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology Zhongshan Hospital, Shanghai Institute of Medical Imaging, National Clinical Research Center of Interventional Medicine, Fudan 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