The prognostic impact of mild and severe immune-related adverse events in non-small cell lung cancer treated with immune checkpoint inhibitors: a multicenter retrospective study.

Abstract

Patients treated with immune checkpoint inhibitors (ICIs) often experience unique immune-related adverse events (irAEs), and the previous studies demonstrated an association between irAEs and better outcomes in patients with ICI treatment for advanced non-small cell lung cancer (NSCLC). However, the correlation between the occurrence of mild and severe irAEs and prognosis remains unclear. Additionally, little is known regarding the association between the timing of mild and severe irAEs and clinical outcomes. We retrospectively conducted a multicenter study of advanced NSCLC patients treated with ICI monotherapy. Of the 222 patients, 79 patients (35.6%) experienced at least one irAE, and most were of grade 1 or 2 (mild) (26.6%). The most common irAEs were pneumonitis (n = 21, 9.5%) and skin-related adverse reactions (n = 19, 8.6%). The median progression-free survival of all patients treated with ICIs was 3.2 months. Patients experiencing irAEs had a better prognosis than those without such events (6.5 vs. 2.6 months, p = 0.004), and mild irAEs were associated with the best prognosis. The difference in overall survival between mild and severe irAEs was significant (34.3 vs. 17.3 months, p = 0.021). We further analyzed differences between patients with irAEs occurring at 3 or 6 weeks, and found that the earlier the occurrence of mild irAEs, the better the prognosis; however, the opposite was true for severe irAEs. In summary, patients with early occurring mild irAEs showed better clinical outcomes, whereas those with early severe irAEs tended to show poorer clinical outcomes.

• Authors: Wenxian Wang, Xiaodong Gu, Liping Wang, Xingxiang Pu, Huijing Feng, Chunwei Xu, Guangyuan Lou, Lan Shao, Yibing Xu, Qian Wang, Siyuan Wang, Wenbin Gao, Yiping Zhang, Zhengbo Song
• Journal: Cancer immunology, immunotherapy : CII (Cancer Immunol Immunother) Vol. 71 Issue 7 Pg. 1693-1703 (Jul 2022) ISSN: 1432-0851 [Electronic] Germany
• PMID: 34817639 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Antineoplastic Agents, Immunological
• Immune Checkpoint Inhibitors
• Nivolumab

Topics

• Antineoplastic Agents, Immunological (adverse effects)
• Carcinoma, Non-Small-Cell Lung
• Drug-Related Side Effects and Adverse Reactions
• Humans
• Immune Checkpoint Inhibitors (adverse effects)
• Lung Neoplasms
• Nivolumab (therapeutic use)
• Prognosis
• Retrospective Studies