Recently immune checkpoint inhibitors amazingly changed the landscape of cancer therapy worldwide. The number of immune checkpoint molecules in clinical practice is constantly increasing. There are some monoclonal antibodies recently registered in the Russian Federation: anti-PD1 antibodies (nivolumab, pembrolizumab), anti-PD-L1 (atezolizumab, durvalumab), anti-CTLA-4 (ipilimumab). Immune-mediated endocrinopathies are some of the most common complications of immunotherapy. According to the results of clinical studies, the incidence of serious endocrine immuno-mediated adverse events with anti-PD1 monoclonal antibodies is low (3.5–8%). The use of anti-CTLA4 antibodies, combined regimens, and the use of immunotherapy after chemoradiotherapy significantly increase the incidence of serious adverse events to 30%. In clinical practice of N.N. Blokhin Cancer Research Center among 245 non-small cell lung cancer and hepatocellular carcinoma patients treated with immunotherapy, 22 (8,9%) developed an immune-mediated endocrinopathy. Most patients developed adverse events of 1–2 degrees, in two patients – 3 degrees, requiring discontinuation of treatment. The aim of this article was to provide useful information and recommendations regarding the management of common immuno-related endocrine adverse events (including hypothyroidism, hyperthyroidism, pituitary, adrenal insufficiency) for clinical oncologists.

The development of immune checkpoint inhibitors has altered the landscape of treatment of advanced cancers including non-small cell lung cancer (NSCLC). Nivolumab is the PD-1 inhibitor approved for the treatment of NSCLC to show a survival benefit in a randomised phase III trials. The experience of physicians in routine clinical practice is often different from those in a controlled clinical trial setting. The purpose of this analysis is to evaluate nivolumab use in real world setting.

Aim of the study: to evaluate prognostic value of baseline lung immune prognostic index (LIPI) and its modification (mLIPI) for metastatic non-small cell lung cancer (mNSCLC) patients treated with immune checkpoint inhibitors (ICI).Material and methods. Baseline neutrophil-to-lymphocyte ratio, lactate dehydrogenase, hemoglobin, platelets, and fibrinogen level were collected from 133 patients treated with ICI in monotherapy or combination between July 2015 and July 2022 in N.N. Blokhin NMRCO. According to evaluating factors patients were divided into three groups of “good” (LIPI 0/mLIPI 0–1), “intermediate” (LIPI 1/mLIPI 2–3) and “poor” prognosis (LIPI 2/mLIPI 4–5). The primary endpoint was progression free survival (PFS).Results. The median PFS for the LIPI groups were 9.7 months (1.4–17.9; 95 % CI), 7.9 months (5.9–9.9; CI 95 %) and 6.0 months (4.07–7.93; 95 % CI) in the “good”, “intermediate” and “poor” prognosis groups, respectively; the hazard ratio (HR) for patients in the “poor” prognosis group (17 patients) was 2.02 (1.06–3.84; 95 % CI) compared with the “good” LIPI group (p=0.03). The median PFS for mLIPI groups were 9.0 months (4.53–13.47; 95 % CI), 8.0 months (5.4–10.6; CI 95 %) and 2.0 months. (1.33–2.67; 95 % CI) in the “good”, “intermediate” and “poor” prognosis groups, respectively. The HR for patients in the “poor” prognosis group (n=12) was 3.12 (1.51–6.46; 95 % CI) compared with the “good” mLIPI group (p=0.002).Conclusion. Baseline LIPI and mLIPI predicts potential resistance to ICI treatment in mNSCLC patients.

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