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Is Timing of Steroid Exposure Prior to Immune Checkpoint Inhibitor Initiation Associated with Treatment Outcomes in Melanoma? A Population-Based Study

Authors :
Nikita, Nikita
Banks, Joshua
Keith, Scott W.
Song, Andrew
Johnson, Jennifer M.
Wilson, Melissa
Sharma, Swapnil
Lu-Yao, Grace
Nikita, Nikita
Banks, Joshua
Keith, Scott W.
Song, Andrew
Johnson, Jennifer M.
Wilson, Melissa
Sharma, Swapnil
Lu-Yao, Grace
Source :
Department of Medical Oncology Faculty Papers
Publication Year :
2022

Abstract

Immune checkpoint inhibitors (ICIs) harness the immune system and are the therapy of choice for multiple cancers. Although immunosuppressive agents such as steroids are also used in many cancers, it is unknown how their timing affects treatment outcomes. Thus, we investigated the relationship between the timing of steroid exposure preceding ICI administration and subsequent treatment outcomes in melanoma. This population-based study utilized the SEER-Medicare-linked database to identify patients diagnosed with melanoma between 1991 and 2015 and receiving ICIs between 2010 and 2016, examining last steroid exposure in the 12 months preceding ICI. The main outcome was all-cause mortality (ACM) after ICIs. Modifications of the Cox proportional hazards model were used to calculate time-dependent hazards. Of 1671 patients with melanoma receiving ICIs, 907 received steroids. Compared with no steroids, last steroid exposures ≤1 month and 1–3 months prior to ICIs were associated with a 126% and 51% higher ACM within 3 months post ICI initiation, respectively (hazard ratio (HR): 2.26, 95% CI: 1.65–3.08; and HR: 1.51, 95% CI: 1.01–2.27). Steroid exposure within 3 months of initiating ICIs was associated with increased mortality up to 6 months after ICI. Further investigation is warranted to elucidate mechanisms affecting outcomes due to steroids.

Details

Database :
OAIster
Journal :
Department of Medical Oncology Faculty Papers
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1319182438
Document Type :
Electronic Resource