P3.02c-029 Immune-Related Adverse Events and Their Effect on Outcomes in Patients (pts) with Non-Small Cell Lung Cancer (NSCLC) Treated with Nivolumab

Kothari, Shawn; Bagley, Stephen; Aggarwal, Charu; Bauml, Joshua; Alley, Evan; Evans, Tracey L.; Kosteva, John A.; Ciunci, Christine; Thompson, Jeffrey C.; Stonehouse-Lee, Susan; Sherry, Victoria E.; Gilbert, Elizabeth; Eaby-Sandy, Beth; Mutale, Faith; DiLullo, Gloria A; Cohen, Roger B.; Vachani, Anil; Langer, Corey J.

doi:10.1016/j.jtho.2016.11.1824

Cited by 9 publications

(9 citation statements)

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“…Although better outcomes have been suggested for patients who experienced irAEs by some series, others have found no correlation . Where patients required immunosuppression in these studies, almost all were treated with corticosteroids only.…”

Section: Discussionmentioning

confidence: 86%

“…others have found no correlation 7,22. Where patients required immunosuppression in these studies, almost all were treated with corticosteroids only.…”

mentioning

confidence: 67%

“…Horvat et al. also did not report any effect of immunosuppression on survival in their cohort of patients, of whom 31 were steroid‐refractory and received additional immunosuppressive agents …”

Section: Discussionmentioning

confidence: 90%

“…Conversely, there is not a clear indication that the additional immunosuppressive treatment limits the anticancer effects of checkpoint inhibitor therapy in this small case series. Horvat et al also did not report any effect of immunosuppression on survival in their cohort of patients, of whom 31 were steroid-refractory and received additional immunosuppressive agents 7,22. Detailed analyses of the effect of different immunosuppressive agents such as TNF inhibitors, which were used to control irAEs, on patient survival have not yet been reported for the CheckMate 067 study.…”

mentioning

confidence: 96%

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Cancer outcomes in patients requiring immunosuppression in addition to corticosteroids for immune‐related adverse events after immune checkpoint inhibitor therapy

Burdett

Hsu

Xiong

et al. 2019

Asia-Pac J Clncl Oncology

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Aim To examine the cancer‐specific outcomes for patients who experience immune‐related adverse events requiring immunosuppression beyond corticosteroids. Methods We performed a retrospective case series of patients between January 1, 2009 and April 1, 2018, across three metropolitan hospitals in Adelaide, South Australia. Eligible patients were identified from pharmacy records. Patients with a solid organ malignancy had discontinued checkpoint inhibitor therapy due to toxicity, and required immunosuppression in addition to corticosteroids to treat any immune‐related adverse event. Results From 3860 patient dispensation records of immunosuppressive medications, 19 eligible patients were identified. Eight received a CTLA‐4 inhibitor, four a PD‐1 inhibitor, five combination immunotherapy, and two remained blinded. Sixteen patients had melanoma and three had non‐small cell lung cancer. Median time to treatment failure was 8.7 months, and median overall survival was 9.4 months. Of those evaluable, the objective response rate was 35%, while 53% had progressive disease. Four patients died due to complications of their irAE, while six died from progressive disease. Conclusion Patients who received immunosuppression for checkpoint inhibitor therapy toxicity had variable outcomes. This in part reflects a heterogeneous population, and the evolution of irAE management over time. Several patients continued to derive a benefit after cessation of therapy despite the use of immunosuppressive medications; conversely, four died as a direct consequence of their irAE. Physicians should promptly introduce immunosuppressive therapy in patients not responding to corticosteroids to mitigate the risk of life‐threatening adverse events, given that current evidence does not clearly demonstrate a detriment to cancer‐specific outcomes.

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Section: Discussionmentioning

confidence: 86%

“…others have found no correlation 7,22. Where patients required immunosuppression in these studies, almost all were treated with corticosteroids only.…”

mentioning

confidence: 67%

Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 96%

See 2 more Smart Citations

Cancer outcomes in patients requiring immunosuppression in addition to corticosteroids for immune‐related adverse events after immune checkpoint inhibitor therapy

Burdett

Hsu

Xiong

et al. 2019

Asia-Pac J Clncl Oncology

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“…The impact of irAEs on OSin cancer patients treated with ICIs was assessed in 20 studies. 11,16–19,23,26–28,31,33–40 Among them, 1731 cancer patients presented at least one of the reported irAEs, and 1991 cases were absent from irAEs. The random-effect model was applied ( p < 0.01, I 2 = 90%).…”

Section: Resultsmentioning

confidence: 99%

The association between immune-related adverse events and the prognosis of solid cancer patients treated with immunotherapy: a systematic review and meta-analysis

et al. 2020

Ther Adv Med Oncol

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Background: Immune-related adverse events (irAEs) are common during immune checkpoint inhibitor (ICI) treatment and reported to be associated with good survival. This study evaluated the association between onset timing of irAEs and survival of cancer patients treated with ICIs. Methods: Databases including PubMed, Embase, and the Cochrane library were systematically searched to retrieve clinical studies assessing the relationship between irAEs and survival in cancer patients with ICIs. The overall response rate for treatment response and hazard ratio (HR) for overall survival (OS) and progression-free survival (PFS) were calculated using RevMan 5.3. Subgroup analysis in terms of cancer type, ICIs type, region, specific irAEs, accordingly. Results: A total of 34 studies were included. The HRs for OS and PFS in cancer patients with versus without irAEs were 0.57 [95% confidence interval (CI): 0.44, 0.74; p < 0.0001], and 0.50 (95% CI: 0.37, 0.67; p < 0.00001), respectively. The odds ratio for overall response in cancer patients with irAEs was 4.72 (95% CI: 3.48, 6.40; p < 0.00001) compared with those without irAEs. Subgroup analyses suggested that the prognostic role of irAEs was associated with cancer types and region, but not irAEs types. The landmark analysis of OS revealed that there is a non-proportional (early) effect of irAEs on OS in ICI-treated cancer patients (landmark >12 weeks, HROS = 1.08; 95% CI: 0.89, 1.30; p = 0.46). Conclusion: Our findings suggest that the occurrence of irAEs could be a prognostic factor for cancer patients who were treated with ICIs.

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Outcomes associated with immune-related adverse events in metastatic non-small cell lung cancer treated with nivolumab: a pooled exploratory analysis from a global cohort

Naqash

Ricciuti

Owen

et al. 2020

Cancer Immunol Immunother

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P3.02c-029 Immune-Related Adverse Events and Their Effect on Outcomes in Patients (pts) with Non-Small Cell Lung Cancer (NSCLC) Treated with Nivolumab

Cited by 9 publications

References 0 publications

Cancer outcomes in patients requiring immunosuppression in addition to corticosteroids for immune‐related adverse events after immune checkpoint inhibitor therapy

Cancer outcomes in patients requiring immunosuppression in addition to corticosteroids for immune‐related adverse events after immune checkpoint inhibitor therapy

The association between immune-related adverse events and the prognosis of solid cancer patients treated with immunotherapy: a systematic review and meta-analysis

Outcomes associated with immune-related adverse events in metastatic non-small cell lung cancer treated with nivolumab: a pooled exploratory analysis from a global cohort

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