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Association Between Early Immune-related Adverse Events and Clinical Outcomes in Patients With Non-Small Cell Lung Cancer Treated With Immune Checkpoint Inhibitors
- Source :
- Clinical lung cancer. 21(4)
- Publication Year :
- 2019
-
Abstract
- Introduction Previous studies have described an association between immune-related adverse events (irAEs) and better outcomes in patients administered nivolumab for advanced non–small-cell lung cancer. However, the patients in previous studies were not stratified by potential predictive factors, such as programmed cell death ligand 1 status and treatment lines. Additionally, little is known of whether the timing and type of irAEs can inform the prediction of outcomes. Patients and Methods We prospectively investigated the association between irAEs and outcomes in the single-center cohort that included patients administered nivolumab in the second or later line of therapy. Subsequently, we confirmed these findings in a retrospective multicenter cohort that included patients with programmed cell death ligand 1 tumor proportion score of ≥ 50% who had received first-line pembrolizumab. The primary outcome was progression-free survival (PFS). Results In the prospective cohort (n = 76), the median PFS was significantly longer for the patients experiencing irAEs within 2 weeks of beginning nivolumab compared with the PFS for those who did not (median, 5.0 months [95% confidence interval (CI), 2.1-8.6 months] vs. median, 2.0 months [95% CI, 1.9-2.5 months]; P = .046). The association was stronger with earlier (within 2 weeks) than with later (within 6 weeks) irAEs. In the retrospective cohort (n = 148), the median PFS was significantly longer for the patients with early irAEs (within 3 weeks) than for those without (median, not reached [95% CI, 5.9 months to not reached] vs. median, 6.9 months [95% CI, 4.2-9.7 months]; P = .04). Rash was common and a better predictor of outcomes in both cohorts. Conclusion Our results have provided firmer evidence of the association between the occurrence of irAEs and outcomes and suggest that early irAEs (especially rash) might better predict outcomes.
- Subjects :
- 0301 basic medicine
Pulmonary and Respiratory Medicine
Adult
Male
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Drug-Related Side Effects and Adverse Reactions
Pembrolizumab
03 medical and health sciences
0302 clinical medicine
Internal medicine
Carcinoma, Non-Small-Cell Lung
Medicine
Humans
Prospective Studies
Lung cancer
Prospective cohort study
Adverse effect
Immune Checkpoint Inhibitors
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
Prognosis
Rash
Survival Rate
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Cohort
Carcinoma, Squamous Cell
Female
medicine.symptom
Nivolumab
Neoplasm Recurrence, Local
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 19380690
- Volume :
- 21
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Clinical lung cancer
- Accession number :
- edsair.doi.dedup.....014f2f4b8b6e30a62e43325b5bd09a25