Impact of Intercurrent Introduction of Steroids on Clinical Outcomes in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients under Immune-Checkpoint Inhibitors (ICI).
immunotherapy
non-small cell lung cancer
steroids
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
30 Sep 2020
30 Sep 2020
Historique:
received:
05
09
2020
revised:
25
09
2020
accepted:
29
09
2020
entrez:
3
10
2020
pubmed:
4
10
2020
medline:
4
10
2020
Statut:
epublish
Résumé
Baseline steroids before ICI have been associated with poor outcomes, particularly when introduced due to cancer symptoms. Retrospective analysis of advanced NSCLC patients treated with ICI. We collected the use of intercurrent steroids (≥10 mg of prednisone-equivalent) within the first eight weeks of ICI. We correlated steroid use with patient outcomes according to the indications. 413 patients received ICI, 299 were steroids-naïve at baseline. A total of 49 patients received intercurrent steroids (16%), of whom 38 for cancer-related symptoms and 11 for other indications, such as immune-related events. Overall, median (m) progression-free survival (PFS) was 1.9 months (mo.) [95% CI, 1.8-2.4] and overall survival (OS) 10 mo. [95% CI, 8.1-12.9]. Intercurrent steroids under ICI correlated with a shorter PFS/OS (1.3 and 2.3 mo. respectively, both Intercurrent steroids during ICI had no detrimental prognostic impact if the indication was unrelated to cancer symptoms.
Sections du résumé
BACKGROUND
BACKGROUND
Baseline steroids before ICI have been associated with poor outcomes, particularly when introduced due to cancer symptoms.
METHODS
METHODS
Retrospective analysis of advanced NSCLC patients treated with ICI. We collected the use of intercurrent steroids (≥10 mg of prednisone-equivalent) within the first eight weeks of ICI. We correlated steroid use with patient outcomes according to the indications.
RESULTS
RESULTS
413 patients received ICI, 299 were steroids-naïve at baseline. A total of 49 patients received intercurrent steroids (16%), of whom 38 for cancer-related symptoms and 11 for other indications, such as immune-related events. Overall, median (m) progression-free survival (PFS) was 1.9 months (mo.) [95% CI, 1.8-2.4] and overall survival (OS) 10 mo. [95% CI, 8.1-12.9]. Intercurrent steroids under ICI correlated with a shorter PFS/OS (1.3 and 2.3 mo. respectively, both
CONCLUSION
CONCLUSIONS
Intercurrent steroids during ICI had no detrimental prognostic impact if the indication was unrelated to cancer symptoms.
Identifiants
pubmed: 33007977
pii: cancers12102827
doi: 10.3390/cancers12102827
pmc: PMC7599488
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Eur J Cancer. 2020 May;130:155-167
pubmed: 32220780
Nat Rev Immunol. 2017 Apr;17(4):233-247
pubmed: 28192415
Trends Pharmacol Sci. 1998 Aug;19(8):317-21
pubmed: 9745359
N Engl J Med. 2016 Nov 10;375(19):1823-1833
pubmed: 27718847
Sci Rep. 2015 Jul 24;5:12493
pubmed: 26205001
Front Immunol. 2018 Mar 05;9:374
pubmed: 29556232
Cochrane Database Syst Rev. 2019 Feb 20;2:CD012704
pubmed: 30784058
ESMO Open. 2019 Feb 27;4(1):e000457
pubmed: 30964126
J Clin Invest. 2012 Mar;122(3):787-95
pubmed: 22378047
Rev Infect Dis. 1989 Nov-Dec;11(6):954-63
pubmed: 2690289
Ann Oncol. 2017 Jul 1;28(suppl_4):iv119-iv142
pubmed: 28881921
JAMA Oncol. 2018 Mar 1;4(3):351-357
pubmed: 29327044
J Thorac Oncol. 2020 Jun;15(6):914-947
pubmed: 32179179
Ann Oncol. 2018 Jun 1;29(6):1437-1444
pubmed: 29617710
Rheum Dis Clin North Am. 2016 Feb;42(1):157-76, ix-x
pubmed: 26611557
J Neurooncol. 2010 Jan;96(1):103-14
pubmed: 19957014
J Clin Oncol. 2019 Aug 1;37(22):1927-1934
pubmed: 31206316
J Clin Oncol. 2018 Oct 1;36(28):2872-2878
pubmed: 30125216
Arthritis Res Ther. 2011 Aug 31;13(4):R139
pubmed: 21884589
J Clin Oncol. 2019 Aug 1;37(22):1863-1867
pubmed: 30995172
Cancers (Basel). 2020 Feb 27;12(3):
pubmed: 32120803
Int J Mol Sci. 2018 Dec 17;19(12):
pubmed: 30563002
Mol Cell Endocrinol. 2011 Mar 15;335(1):2-13
pubmed: 20398732
Cancer J. 2014 Sep-Oct;20(5):319-24
pubmed: 25299141
JAMA Oncol. 2019 Dec 1;5(12):1774-1778
pubmed: 31513236