Immune-Related Adverse Events and Efficacy of Immune Checkpoint Inhibitors
Posted: Friday, November 30, 2018
The results of a retrospective study, presented at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto, suggest that the efficacy of immune checkpoint inhibitors improves among patients with advanced non–small cell lung cancer (NSCLC) who experience immune-related adverse events (Abstract P1.01-63). The study, led by Margarita Majem Tarruella, MD, of the Hospital de la Santa Creu i Sant Pau, Barcelona, observed “superior” overall and progression-free survival among patients with adverse events.
Patients diagnosed with NSCLC receiving immune checkpoint inhibitors (n = 101) were retrospectively evaluated for progression-free survival, overall survival, and immune-related adverse events. Patients were most frequently treated with nivolumab (50%), pembrolizumab (31%), and atezolizumab (16%) as monotherapy or in combination with chemotherapy. The study included patients receiving treatment in the first-line or second-line setting and beyond.
In total, 60.4% of patients developed 106 immune-related adverse events. Among them, rash (24.5%), pruritus (22.6%), diarrhea (21%), arthritis (8.5%), hypothyroidism (7.6%), and hyperthyroidism (2.9%) were the most common side effects. Those who received treatment in the second-line setting or beyond experienced fewer adverse events than did those who received first-line therapy (54.1% vs. 73.7%, P = .04).
The median overall survival was significantly longer in patients experiencing adverse events compared with those who did not (8.9 months vs. 7.8 months; P < .0001). Progression-free survival also improved (6.2 months vs. 2.7 months, respectively). However, the use of steroids was associated with a reduced efficacy of immune checkpoint inhibitors.