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Immune-Related Adverse Events and Corticosteroid Use for Cancer-Related Symptoms Are Associated With Efficacy in Patients With Non-small Cell Lung Cancer Receiving Anti-PD-(L)1 Blockade Agents
Riudavets, Mariona (Universitat Autònoma de Barcelona. Departament de Medicina)
Mosquera, Joaquin (Complejo Hospitalario Universitario de A Coruña)
García-Campelo, Rosario (Complejo Hospitalario Universitario de A Coruña)
Serra, Jorgina (Institut d'Investigació Biomèdica Sant Pau)
Anguera, Georgia (Institut d'Investigació Biomèdica Sant Pau)
Gallardo, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Sullivan, Ivana (Institut d'Investigació Biomèdica Sant Pau)
Barba Joaquin, Andrés (Institut d'Investigació Biomèdica Sant Pau)
del Carpio, Luís (Institut d'Investigació Biomèdica Sant Pau)
Barnadas i Molins, Agustí (Institut d'Investigació Biomèdica Sant Pau)
Gich, Ignasi (Institut d'Investigació Biomèdica Sant Pau)
Majem, Margarita (Institut d'Investigació Biomèdica Sant Pau)

Date: 2020
Abstract: Background: Immune-related adverse events (irAEs) have been associated with improved efficacy in advanced non-small cell lung cancer (NSCLC) patients receiving anti-PD-(L)1 blockade agents, while the concurrent use of corticosteroids seems to worsen it. We evaluated outcomes in advanced NSCLC patients treated with anti-PD-(L)1 blockade agents in relation to the presence of irAEs and the reasons for using corticosteroids: whether for palliative cancer-related reasons or for the management of irAEs. Methods: Clinical outcomes in advanced NSCLC patients treated with anti-PD-(L)1 blockade agents were calculated with regard to the presence of irAEs and the use of corticosteroids. A landmark analysis was performed to avoid immortal time bias due to the time-dependent nature of irAEs. Results: Out of a total of 267 patients, the 56. 9% of patients who experienced irAEs had significantly improved outcomes. In the landmark analysis, median progression-free survival (PFS) was 12. 4 months for patients with irAEs vs. 4. 1 months for patients without irAEs (p < 0. 001), while median overall survival (OS) was 28. 2 vs. 12. 5 months, respectively (p < 0. 001). Likewise, objective response and disease control rates were significantly higher in patients experiencing irAEs: 48. 6 vs. 22. 8% and 77. 1 vs. 39. 6% (p < 0. 001), respectively. Median OS was significantly shorter for patients receiving ≥10 mg of prednisone equivalent daily for cancer-related symptoms than for the rest of patients (<10 mg prednisone equivalent daily or for management of irAEs): 6 vs. 15. 9 months (p < 0. 001). Conclusions: IrAEs were associated with improved efficacy in advanced NSCLC patients when a landmark analysis was applied. Patients receiving corticosteroids had significantly poorer outcomes when they were used for cancer-related symptoms.
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Language: Anglès
Document: Article ; recerca ; Versió publicada
Subject: Immune-related adverse events ; Immunotherapy ; Advanced NSCLC ; Corticosteroids ; Efficacy
Published in: Frontiers in Oncology, Vol. 10 (september 2020) , ISSN 2234-943X

DOI: 10.3389/fonc.2020.01677
PMID: 33014837


11 p, 544.2 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles

 Record created 2022-02-07, last modified 2024-02-21



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