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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Friday, July 18, 2025
Baseline steroid use, particularly at high doses, was linked with worse outcomes for patients with non–small cell lung cancer (NSCLC) who are receiving immune checkpoint inhibitor therapy, according to the results of a study published in Cancer Research Communications. Further, steroid use was associated with reduced circulating differentiated effector T cells in these patients.
The impact of corticosteroid use in patients with NSCLC, which is often prescribed palliatively, is not well understood, so investigators conducted a study of 277 patients with NSCLC who were undergoing immune checkpoint inhibitor therapy at two institutions.
Lower overall response rates and shorter survival outcomes were reported for patients who had received steroids compared with those who had not. Multivariate analysis indicated that steroid use was a significant independent risk factor for disease progression and mortality for patients at each institution.
The baseline frequency of circulating CX3CR1+CD8+ T cells was substantially lower in patients on steroids compared with those not on steroids. When tested in mice with MC38 tumors, concurrent steroid use was found to significantly diminish the efficacy of anti–PD-1 therapy and lower the frequency of CX3CR1+CD8+ T cells. On the other hand, discontinuing steroids at the start of immunotherapy did not negatively impact survival for these mice.
The study authors, including corresponding author Fumito Ito, MD, PhD, of the Department of Surgery, Molecular Microbiology and Immunology, University of Southern California, noted that caution should be taken when interpreting the results of circulating immune-related prognostic biomarkers in patients on steroids at the start of immunotherapy treatment.
Disclosure: For full disclosures of the study authors, visit aacrjournals.org.
Cancer Research Communications
