Immune-Related Adverse Events, Biomarkers of Systemic Inflammation, and Survival Outcomes in Patients Receiving Pembrolizumab for Non-Small-Cell Lung Cancer.
Scottish Inflammatory Prognostic Score (SIPS)
biomarkers of systemic inflammation
immune-related adverse events
non-small-cell lung cancer
pembrolizumab
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
21 Nov 2023
21 Nov 2023
Historique:
received:
12
10
2023
revised:
08
11
2023
accepted:
08
11
2023
medline:
9
12
2023
pubmed:
9
12
2023
entrez:
9
12
2023
Statut:
epublish
Résumé
Pembrolizumab monotherapy for non-small-cell lung cancer (NSCLC) expressing PD-L1 ≥ 50% doubles five-year survival rates compared to chemotherapy. However, immune-related adverse events (irAEs) can cause severe, long-term toxicity necessitating high-dose steroids and/or treatment cessation. Interestingly, patients experiencing irAEs demonstrate better survival outcomes. Biomarkers of systemic inflammation, including the Scottish Inflammatory Prognostic Score (SIPS), also predict survival in this patient group. This study examines the relationship between inflammatory status, irAEs, and survival outcomes in NSCLC. A retrospective analysis was conducted on patients with NSCLC expressing PD-L1 ≥ 50% receiving first-line pembrolizumab monotherapy at a large cancer centre in Scotland. Regression analyses were conducted to examine the relationship between SIPS, irAEs, and survival. 83/262 eligible patients (32%) experienced an irAE. Dermatological, endocrine, gastrointestinal, and hepatic, but not pulmonary, irAEs were associated with prolonged PFS and OS ( The occurrence of certain irAEs is associated with a survival benefit in patients with NSCLC expressing PD-L1 ≥ 50% receiving pembrolizumab. We find that the association between low levels of systemic inflammation and the risk of irAEs is confounded by their independent prognostic value.
Sections du résumé
BACKGROUND
BACKGROUND
Pembrolizumab monotherapy for non-small-cell lung cancer (NSCLC) expressing PD-L1 ≥ 50% doubles five-year survival rates compared to chemotherapy. However, immune-related adverse events (irAEs) can cause severe, long-term toxicity necessitating high-dose steroids and/or treatment cessation. Interestingly, patients experiencing irAEs demonstrate better survival outcomes. Biomarkers of systemic inflammation, including the Scottish Inflammatory Prognostic Score (SIPS), also predict survival in this patient group. This study examines the relationship between inflammatory status, irAEs, and survival outcomes in NSCLC.
METHODS
METHODS
A retrospective analysis was conducted on patients with NSCLC expressing PD-L1 ≥ 50% receiving first-line pembrolizumab monotherapy at a large cancer centre in Scotland. Regression analyses were conducted to examine the relationship between SIPS, irAEs, and survival.
RESULTS
RESULTS
83/262 eligible patients (32%) experienced an irAE. Dermatological, endocrine, gastrointestinal, and hepatic, but not pulmonary, irAEs were associated with prolonged PFS and OS (
CONCLUSION
CONCLUSIONS
The occurrence of certain irAEs is associated with a survival benefit in patients with NSCLC expressing PD-L1 ≥ 50% receiving pembrolizumab. We find that the association between low levels of systemic inflammation and the risk of irAEs is confounded by their independent prognostic value.
Identifiants
pubmed: 38067207
pii: cancers15235502
doi: 10.3390/cancers15235502
pmc: PMC10705211
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Cancer Research UK
ID : n/a
Pays : United Kingdom
Références
Front Pharmacol. 2023 May 22;14:1190001
pubmed: 37284302
JAMA Oncol. 2018 Mar 01;4(3):374-378
pubmed: 28975219
J Immunother Cancer. 2020 Nov;8(2):
pubmed: 33219093
N Engl J Med. 2016 Nov 10;375(19):1823-1833
pubmed: 27718847
Cancer Treat Rev. 2022 Nov;110:102452
pubmed: 35998515
Front Nutr. 2021 Oct 01;8:734735
pubmed: 34660664
Ann Oncol. 2019 Oct 1;30(10):1653-1659
pubmed: 31435660
Ann Oncol. 2022 Dec;33(12):1217-1238
pubmed: 36270461
Front Oncol. 2021 Sep 15;11:708195
pubmed: 34604047
N Engl J Med. 2018 May 31;378(22):2078-2092
pubmed: 29658856
Thorac Cancer. 2021 Aug;12(15):2198-2204
pubmed: 34173724
J Crit Care. 2016 Dec;36:195-199
pubmed: 27546771
Front Oncol. 2021 Mar 23;11:630136
pubmed: 33833990
Lancet Oncol. 2023 May;24(5):e219-e227
pubmed: 37142383
Oncologist. 2018 Nov;23(11):1358-1365
pubmed: 29934411
Int J Radiat Oncol Biol Phys. 2020 Jan 1;106(1):5-12
pubmed: 31404580
J Immunother Cancer. 2022 Feb;10(2):
pubmed: 35210308
Br J Cancer. 2007 Nov 5;97(9):1266-70
pubmed: 17923866
Clin Epidemiol. 2018 Aug 30;10:1109-1125
pubmed: 30214315
BMC Cancer. 2019 Nov 14;19(1):1102
pubmed: 31727024
Lung Cancer. 2015 Jun;88(3):304-9
pubmed: 25870155
Oncologist. 2019 Sep;24(9):e960-e967
pubmed: 30975922
Int Immunopharmacol. 2021 Oct;99:108031
pubmed: 34358857
N Engl J Med. 2018 Nov 22;379(21):2040-2051
pubmed: 30280635
Biosci Trends. 2020 Mar 16;14(1):48-55
pubmed: 32023563
ESMO Open. 2022 Apr;7(2):100445
pubmed: 35398717
J Clin Oncol. 2020 Jan 1;38(1):105-106
pubmed: 31675246
Clin Lung Cancer. 2022 Dec;23(8):731-736
pubmed: 35945127
Biomedicines. 2022 Mar 28;10(4):
pubmed: 35453540
Sci Rep. 2021 Jan 14;11(1):1324
pubmed: 33446685
Pharmazie. 2021 May 1;76(5):239-242
pubmed: 33964999
Cancer Immunol Immunother. 2021 Nov;70(11):3069-3080
pubmed: 34195862
Front Immunol. 2021 May 28;12:663986
pubmed: 34122422
J Thorac Dis. 2018 Sep;10(9):5298-5307
pubmed: 30416777
Front Immunol. 2022 Apr 26;13:779691
pubmed: 35558065
J Clin Oncol. 2016 Aug 10;34(23):2769-75
pubmed: 27354484
J Clin Oncol. 2019 Mar 1;37(7):537-546
pubmed: 30620668
J Clin Oncol. 2019 Apr 10;37(11):867-875
pubmed: 30811280
Thorac Cancer. 2022 Mar;13(5):724-731
pubmed: 35044093
Front Oncol. 2021 Jun 29;11:703893
pubmed: 34268127
Cancers (Basel). 2020 Feb 27;12(3):
pubmed: 32120803
Clin Cancer Res. 2021 Nov 1;27(21):5993-6000
pubmed: 34376536
JAMA Oncol. 2023 Apr 1;9(4):527-535
pubmed: 36795388
N Engl J Med. 2018 Jan 11;378(2):158-168
pubmed: 29320654
Crit Rev Oncol Hematol. 2018 Dec;132:130-137
pubmed: 30447918
Transl Lung Cancer Res. 2021 Jan;10(1):355-367
pubmed: 33569318
Clin Lung Cancer. 2018 Nov;19(6):e893-e900
pubmed: 30197259
Cancer Treat Rev. 2013 Aug;39(5):534-40
pubmed: 22995477
Contemp Clin Trials. 2023 Jan;124:107030
pubmed: 36519749
BMJ Open. 2020 Jun 3;10(6):e035031
pubmed: 32499266
Sci Rep. 2016 Mar 30;6:23893
pubmed: 27025911
Oncologist. 2019 Aug;24(8):1128-1136
pubmed: 31015312