Immune checkpoint inhibition for non-small cell lung cancer in patients with pulmonary tuberculosis or Hepatitis B: Experience from a single Asian centre

Chan, Gloria; Gwee, Yong Xiang; Low, Jia Li; Huang, Yiqing; Chan, Zhi Yao; Choo, Joan R.E.; Ngoi, Natalie Yl; Ang, Yvonne; Muthu, Vaishnavi; Chong, Wan Qin; Wong, Alvin Seng Cheong; Soo, Ross A.

doi:10.1016/j.lungcan.2020.05.020

Cited by 19 publications

(31 citation statements)

References 38 publications

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“…These results are shown in Table 3 and Figure 1. (14)(15)(16)(17)(18)(19)(20). Most of the relevant studies have enrolled a limited number of patients, impeding in-depth characterization of the safety and efficacy of immunotherapy.…”

Section: Efficacymentioning

confidence: 99%

“…In a retrospective study enrolling NSCLC patients with a history of tuberculosis (TB) and/or HBV who were treated with ICI (monotherapy or combination therapy), patients in the group with HBV or TB appeared to have better survival outcomes compared with the group without, in terms of PFS (5.7 vs. 3.1 months; P=0.021) and OS (15.6 vs. 11.1 months, P=0.046) (19). Of note, the group with TB or HBV included a higher proportion of patients receiving ICI in the first-line setting with PD-L1 expression ≥1%.…”

Section: Pd-1 Pathway Inhibitors Have Become a Cornerstone In The Treatment Of Patients With Nononcogene Addicted Advancedmentioning

confidence: 99%

“…A clinical trial (NCT00703469) that assessed an anti-PD-1 antibody in patients with chronic HCV infection showed that some patients have persistent suppression of HCV replication. However, there are case reports or case series indicating that HBV reactivation is a potential complication of anti-PD-(L)1 therapy in HBVinfected patients with cancers (16,17,19,28,37). In our previous pan-cancer study, we found that HBV reactivation occurs in 5.3% of the patients with positive HBsAg, and that the lack of prophylactic antiviral therapy was the most important risk factor [odds ratio (OR) 17.50] (28).…”

Section: Pd-1 Pathway Inhibitors Have Become a Cornerstone In The Treatment Of Patients With Nononcogene Addicted Advancedmentioning

confidence: 99%

“…According to AASLD guidance (30), the administration of antiviral therapy should last for at least 6 months after completion of immunosuppressive agents or chemotherapy, but whether this recommendation is applicable for immunotherapy remains to be determined. For RHB patients, who are at lower risk of HBV reactivation than are CHB patients (19), treatment can begin on prophylaxis, or ALT, HBV DNA, and HBsAg can be carefully monitored with the intent for on-demand anti-HBV therapy (30).…”

Section: Pd-1 Pathway Inhibitors Have Become a Cornerstone In The Treatment Of Patients With Nononcogene Addicted Advancedmentioning

confidence: 99%

“…Recently, some retrospective studies or prostective clinical trials have demonstrated that the efficacy and limited toxicity of PD-(L)1 inhibitors in patients with HIV infection and advanced NSCLC is similar to non-infected patients (9)(10)(11)(12)(13). However, data from the literature have been limited to case reports or small case series that have described the utilization of PD-1 pathway inhibitor (alone or in combination with ipilimumab or chemotherapy) for advanced NSCLC patients with chronic or previous HBV infection (14)(15)(16)(17)(18)(19)(20). Therefore, there is a paucity of information on the safety and efficacy of anti-PD-(L)1 monotherapy in this population.…”

Section: Introductionmentioning

confidence: 99%

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Association of hepatitis B virus infection status with outcomes of non-small cell lung cancer patients undergoing anti-PD-1/PD-L1 therapy

Zhang¹,

Tian²,

Chen³

et al. 2021

Transl Lung Cancer Res

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Background: The aim of this study was to evaluate the safety and survival outcomes of anti-programmed cell death (PD)-1/programmed cell death-ligand 1 (PD-L1) monotherapy in patients with advanced nonsmall cell lung cancer (NSCLC) and different hepatitis B virus (HBV) infection status.Methods: Patients with advanced NSCLC and both chronic and/or resolved HBV infection who were treated with anti-PD-(L)1 monotherapy were retrospectively enrolled. The primary endpoint was the safety of PD-1/PD-L1 monotherapy, while the secondary endpoints included the survival outcomes.Results: Of the 62 eligible patients, 10 (16.1%) were hepatitis B surface antigen (HBsAg) positive [chronic hepatitis B (CHB) infection] and 52 (83.9%) were HBsAg negative and HBcAb positive [resolved hepatitis B (RHB) infection]; 42 (67.7%) patients had at least 1 treatment-related adverse event (AE), with 4 patients (6.5%) developing grade 3 AEs and 6 (9.7%) developing hepatic AEs. One CHB patient experienced HBV reactivation during anti-PD-1 immunotherapy due to the interruption of antiviral prophylaxis. The objective response rate and durable clinical benefit (DCB) rate were 17.7% and 29.0%, respectively. Median overall survival (OS) and progression-free survival (PFS) were 23.6 months [95% confidence interval (CI): 14.4-32.8] and 2.1 months (95% CI: 1.2-3.0), respectively. The DCB rate was significantly higher in the CHB group than in the RHB group (60% vs. 23.1%; P=0.048). Patients with CHB experienced a longer PFS (8.3

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Section: Efficacymentioning

confidence: 99%

Section: Pd-1 Pathway Inhibitors Have Become a Cornerstone In The Treatment Of Patients With Nononcogene Addicted Advancedmentioning

confidence: 99%

Section: Pd-1 Pathway Inhibitors Have Become a Cornerstone In The Treatment Of Patients With Nononcogene Addicted Advancedmentioning

confidence: 99%

Section: Pd-1 Pathway Inhibitors Have Become a Cornerstone In The Treatment Of Patients With Nononcogene Addicted Advancedmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Association of hepatitis B virus infection status with outcomes of non-small cell lung cancer patients undergoing anti-PD-1/PD-L1 therapy

Zhang¹,

Tian²,

Chen³

et al. 2021

Transl Lung Cancer Res

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Immune Checkpoint Inhibitors and Tuberculosis Infection in Lung Cancer: A Case Series and Systematic Review With Pooled Analysis

Peng

Liang

et al. 2022

The Journal of Clinical Pharma

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The association between immune checkpoint inhibitors (ICIs) and tuberculosis (TB) infection in patients with lung cancer remains largely elusive. We performed a systematic review and conducted a retrospective analysis of TB infection in patients with lung cancer and ICI exposure to assess the clinical characteristics and outcomes using PubMed, EMBASE, and the Cochrane Library. The time interval from ICI administration to diagnosis of TB between patients with and without a history of TB was compared using Kaplan-Meier analysis. A multivariate Cox regression model was used to identify potential risk factors associated with the time interval of TB development. Twenty-four studies including 53 patients with lung cancer were included. The median age of the patients was 64 years. Eight patients had a history of TB. The median time interval from ICI administration to TB diagnosis was 3 months. In retrospective analysis, 5 (1.16%, 95%CI 0.38% to 2.68%) patients with lung cancer developed TB during ICI treatment. The median time interval was 10.4 months. In a pooled analysis, the median time interval in the without-TB and with-TB groups was 7.00 and 2.35 months, respectively (P = .034). Multivariate Cox regression analyses revealed a history of TB to be an independent factor affecting the time interval of TB activation in patients with lung cancer and ICI exposure (HR 3.59; 95%CI 1.17 to 11.02; P = .026). Therefore, TB infection should be considered in patients with lung cancer during or after ICI treatment. Moreover, we found TB history to be a positive risk factor for a shorter median time interval from ICI to TB diagnosis in patients with lung cancer receiving ICI.

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Hepatitis B virus reactivation in patients undergoing immune checkpoint inhibition: systematic review with meta-analysis

Ding

Meng

Xue

et al. 2022

J Cancer Res Clin Oncol

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Immune checkpoint inhibition for non-small cell lung cancer in patients with pulmonary tuberculosis or Hepatitis B: Experience from a single Asian centre

Cited by 19 publications

References 38 publications

Association of hepatitis B virus infection status with outcomes of non-small cell lung cancer patients undergoing anti-PD-1/PD-L1 therapy

Association of hepatitis B virus infection status with outcomes of non-small cell lung cancer patients undergoing anti-PD-1/PD-L1 therapy

Immune Checkpoint Inhibitors and Tuberculosis Infection in Lung Cancer: A Case Series and Systematic Review With Pooled Analysis

Hepatitis B virus reactivation in patients undergoing immune checkpoint inhibition: systematic review with meta-analysis

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