Correlation Between Immune-Related Adverse Events and Prognosis in Hepatocellular Carcinoma Patients Treated With Immune Checkpoint Inhibitors

Abstract

BackgroundImmune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs) were associated with clinical benefit in cancer patients of melanoma, a lung cancer. In the present study, we investigated the correlation between irAE and ICI efficacy in hepatocellular carcinoma (HCC) patients.MethodsWe divided the HCC patients who received the anti-PD-1 antibody into two groups as irAE group and non-irAE group according to the National Cancer Institute Common Terminology Criteria for Adverse Events ver. 4.03. The treatment efficacy of ICIs was evaluated with objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS).ResultOf the 65 HCC patients who received the anti-PD-1 antibody (monotherapy or combined with targeted medicine), median PFS in the irAE group was superior to that in the non-irAE group (302 days vs. 148 days, p = 0.004). Median OS in the irAE group was also better than that in the non-irAE group (374 days vs. 279 days, p = 0.038). Although the statistical difference for DCR in the irAE group and non-irAE group was not reached, the DCR of the irAE displayed a trend better than that of the non-irAE group (41.20% vs. 20.80%, p = 0.118). Multivariate analysis also demonstrated that the non-irAE group (HR = 6.410, 95% CI: 1.404 to 29.275) was associated independently with the poor prognosis.ConclusionsDevelopment of irAEs was associated with clinical benefit for HCC patients who were treated with immune checkpoint inhibitors; irAE, particularly low-grade irAE, was a predictable marker for better ICI treatment efficiency in HCC patients.

Are anti-PD-1-associated immune related adverse events a harbinger of favorable clinical prognosis in patients with gastric cancer?

“…. Our previous study also found that irAEs can also serve as a marker of good prognosis in hepatocellular carcinoma (HCC) [17]. The results that the irAEs associated with better treatment e ciency including DCR, PFS and OS in AGC was consistent with previous reports.…”

A Case of Hepatocellular Carcinoma Successfully Resumed Atezolizumab and Bevacizumab After Associated Grade 3 Diarrhea and Grade 2 Colitis: Case Report and Literature Review

“… 9 , 10 Interestingly, the development of irAEs was associated with better clinical outcome for HCC patients who were treated with ICIs, although the sample size was small. 16 Corticosteroid therapy is often indicated in the management of cancer-related symptoms such as cachexia, anorexia, edema in the central nervous system, or pain and is recommended by guidelines as first-line therapy for most irAEs. 17 , 18 Recently, Pinato et al reported that there is inadequate evidence about corticosteroid therapy before or during ICI therapy being associated with overall survival and progression-free survival in patients with HCC even at a dose of more than 10 mg/day.…”

Are anti-PD-1-associated immune related adverse events a harbinger of favorable clinical prognosis in patients with gastric cancer?

“…All statistical analyses were performed using SPSS (IBM SPSS 20.0, NY, USA). All P values are two-sided, and p < 0.05 was considered to indicate a statistically significant difference [ 16 ].…”