Clinical outcomes of NSCLC patients experiencing early immune-related adverse events to PD-1/PD-L1 checkpoint inhibitors leading to treatment discontinuation.

Antineoplastic Agents, Immunological / adverse effects B7-H1 Antigen Carcinoma, Non-Small-Cell Lung / pathology Humans Immune Checkpoint Inhibitors / adverse effects Lung Neoplasms / pathology Programmed Cell Death 1 Receptor Retrospective Studies

Early immune-related adverse events Immune checkpoints inhibitors Non-small cell lung cancer Prediction

Journal

Cancer immunology, immunotherapy : CII

ISSN: 1432-0851

Titre abrégé: Cancer Immunol Immunother

Pays: Germany

ID NLM: 8605732

Informations de publication

Date de publication:
Apr 2022

Historique:

received: 06 07 2021

accepted: 23 08 2021

pubmed: 1 9 2021

medline: 17 3 2022

entrez: 31 8 2021

Statut: ppublish

Résumé

The prognostic relevance of early immune-related adverse events (irAEs) in patients affected by non-small cell lung cancer (NSCLC) upon immunotherapy is not fully understood. The Leading to Treatment Discontinuation cohort included 24 patients experiencing severe irAEs after one of two administrations of single anti-PD-1/PD-L1 in any line setting for metastatic NSCLC between November 2015 and June 2019. The control cohort was composed of 526 patients treated with single anti-PD-1/PD-L1 in any line setting with no severe irAE reported. The primary end points were median progression-free survival, overall survival, objective response rate, risk of progression of disease and risk of death. The correlation of clinic pathological features with early severe irAEs represented the secondary end point. Median PFS was 9.3 and 8.4 months, median OS was 12.0 months and 14.2 months at a median follow-up of 18.1 and 22.6 months in the LTD cohort and in the control cohort, respectively. The ORR was 40% (95% CI 17.2-78.8) in the LTD cohort and 32.7% (95% CI 27.8-38.2) in the control cohort. The risk of disease progression was higher in the LTD cohort (HR 2.52 [95% 1.10-5.78], P = .0288). We found no survival benefit in LTD cohort compared to the control cohort. However, early and severe irAEs might underly an immune anti-tumor activation. We identified a significant association with first-line immune checkpoints inhibitors treatment and good PS. Further studies on risk prediction and management of serious and early irAEs in NSCLC patients are needed.

Sections du résumé

BACKGROUND BACKGROUND

The prognostic relevance of early immune-related adverse events (irAEs) in patients affected by non-small cell lung cancer (NSCLC) upon immunotherapy is not fully understood.

METHODS METHODS

The Leading to Treatment Discontinuation cohort included 24 patients experiencing severe irAEs after one of two administrations of single anti-PD-1/PD-L1 in any line setting for metastatic NSCLC between November 2015 and June 2019. The control cohort was composed of 526 patients treated with single anti-PD-1/PD-L1 in any line setting with no severe irAE reported. The primary end points were median progression-free survival, overall survival, objective response rate, risk of progression of disease and risk of death. The correlation of clinic pathological features with early severe irAEs represented the secondary end point.

RESULTS RESULTS

Median PFS was 9.3 and 8.4 months, median OS was 12.0 months and 14.2 months at a median follow-up of 18.1 and 22.6 months in the LTD cohort and in the control cohort, respectively. The ORR was 40% (95% CI 17.2-78.8) in the LTD cohort and 32.7% (95% CI 27.8-38.2) in the control cohort. The risk of disease progression was higher in the LTD cohort (HR 2.52 [95% 1.10-5.78], P = .0288).

CONCLUSIONS CONCLUSIONS

We found no survival benefit in LTD cohort compared to the control cohort. However, early and severe irAEs might underly an immune anti-tumor activation. We identified a significant association with first-line immune checkpoints inhibitors treatment and good PS. Further studies on risk prediction and management of serious and early irAEs in NSCLC patients are needed.

Identifiants

DOI: 10.1007/s00262-021-03045-9 PMID: 34462870

pubmed: 34462870

doi: 10.1007/s00262-021-03045-9

pii: 10.1007/s00262-021-03045-9

doi:

Substances chimiques

Antineoplastic Agents, Immunological 0

B7-H1 Antigen 0

Immune Checkpoint Inhibitors 0

Programmed Cell Death 1 Receptor 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

865-874

Informations de copyright

Références

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