Abstract
BackgroundThe immunotherapy plus chemotherapy combination is one of the most promising treatments in advanced non-small-cell lung cancer (NSCLC). Immunotherapy often causes immune-related adverse events (irAEs), which have been reported to be associated with the good clinical outcomes. However, the effects of immunotherapy plus chemotherapy remain unknown. In this study, we investigated the association between irAEs caused by immunotherapy plus chemotherapy and clinical efficacy in patients with advanced NSCLC.Materials and MethodsWe retrospectively analyzed the data of patients with advanced NSCLC, who received a combination of immunotherapy plus chemotherapy at six institutions in Japan between January 2019 and September 2019. We examined the effect of irAEs on various clinical outcomes.ResultsWe included 70 patients with advanced NSCLC. Patients were divided into two groups: patients with irAEs and patients without irAEs. Patients with irAEs had significantly longer progression-free survival than those without irAEs on univariate (hazard ratio 0.53, 95% confidence interval 0.30–0.93, p = 0.026) and multivariate (hazard ratio 0.53, 95% confidence interval 0.29–0.97, p = 0.041) analyses. In addition, patients with grade 1–2 irAEs (mild irAEs) had significantly longer progression-free and overall survival than those with grade 3-5 irAEs (severe irAEs) or without irAEs on univariate (398 days versus 189 days, respectively; p = 0.0061) and multivariate (not reached versus 412 days, respectively; p = 0.021) analyses.ConclusionPatients with NSCLC who experienced mild irAEs showed better response to treatment with immunotherapy plus chemotherapy than those with severe irAEs or without irAEs. Further large-scale research is warranted to confirm these findings.
Highlights
Lung cancer is the leading cause of cancer deaths [1]
We enrolled 70 patients with advanced non-small-cell lung cancer (NSCLC), who were treated with a combination of immunotherapy plus chemotherapy at six different institutions in Japan (University Hospital Kyoto Prefectural University of Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Japanese Red Cross Kyoto Daini Hospital, UjiTokushukai Medical Center, Otsu City Hospital, and Matsushita Memorial Hospital) between January 2019 and September 2019
We reviewed each patient’s medical records retrospectively and collected the following data: age, sex, histological subtype, tumor–node– metastasis (TNM) stage classified using the TNM stage classification system version 8, adverse events graded using the National Cancer Institute’s Common Terminology Criteria for Adverse Events version 5.0, tumor expression of programmed death-ligand 1 (PD-L1) measured using the PD-L1 IHC 22C3 pharmDx assay (Agilent Technologies, Santa Clara, CA, USA), genomic alteration, response rate, disease control rate assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, Eastern Cooperative Oncology Group (ECOG) performance status (PS), smoking status, treatment regimens, progression-free survival (PFS), and overall survival (OS)
Summary
Lung cancer is the leading cause of cancer deaths [1]. The appearance of immune checkpoint inhibitors (ICIs) has led to major advances in the treatment of lung cancer. Immunerelated adverse events (irAEs) are unique reactions caused by ICIs. the precise mechanisms remain unclear, a number of clinical studies have shown that the occurrence of irAEs correlates with therapeutic response to ICIs in patients with non-small-cell lung cancer (NSCLC) [6,7,8,9]. To date, there is no evidence to support the association between the occurrence of irAEs and the clinical efficacy of immunotherapy combined with chemotherapy. We investigated the association between irAEs caused by immunotherapy plus chemotherapy and clinical efficacy in the real-world setting of patients with advanced NSCLC. The immunotherapy plus chemotherapy combination is one of the most promising treatments in advanced non-small-cell lung cancer (NSCLC).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
