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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Monday, March 18, 2024
Based on the results of a retrospective, observational cohort study, which were published in JAMA Network Open, developing a clinically meaningful immune-related adverse event was associated with improved overall survival in immune checkpoint inhibitor–treated patients with locally advanced or metastatic non–small cell lung cancer (NSCLC). Vishal Navani, MBBS, of Tom Baker Cancer Centre, Calgary, Alberta, Canada, and colleagues did not find this association to be compromised by hospitalization for the management of severe toxic effects.
“Several patient baseline characteristics were associated with immune-related adverse event development in our cohort, including age, Eastern Cooperative Oncology Group performance status, sites of metastasis, PD-L1 expression, and laboratory parameters,” the investigators added. “Response to immune checkpoint inhibitor therapy was the only treatment-related characteristic associated with immune-related adverse event development.”
Using the Alberta Immunotherapy Database, the investigators identified 803 patients who received at least one cycle of treatment with an immune checkpoint inhibitor. Clinically meaningful immune-related adverse events were documented (defined as those mandating delay or discontinuation of immune checkpoint inhibition and/or systematic corticosteroids for the management of toxic effects).
Mitigating immortal time bias (n = 611), the investigators found immune-related adverse events to be associated with overall survival (median, with vs without: 23.7 vs 9.8 months; P < .001). The median duration of overall survival did not appear to significantly differ among patients who underwent inpatient vs outpatient treatment of an immune-related adverse event (20.8 vs 25.6 months; P = .33). The development of immune-related adverse events remained associated with overall survival in the total cohort, based on Cox proportional hazards regression with known prognostic characteristics (hazard ratio = 0.53; P < .001).
“Whether and how immune checkpoint inhibitor therapy resumption after an immune-related adverse event is associated with overall survival warrants further study,” the investigators concluded.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
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