Survival and Early Death Within Three Months from the Start of Immune Checkpoint Inhibitors in Patients With Different Types of Cancer

Abstract

Background/Aim: Implementation of new anti-cancer treatments in rural healthcare might not always result in identical survival outcomes as those seen in the randomized trials leading to approval. Therefore, the survival of patients treated with immune checkpoint inhibitors (ICI) in Nordland county was analyzed. Materials and Methods:Retrospective analysis of 199 patients, mainly treated in adjuvant or palliative settings, e.g. for non-small cell lung cancer (NSCLC) or malignant melanoma (2018)(2019)(2020)(2021).Overall survival and death within 3 months from start of ICI were evaluated. Results:All patients who received (neo)adjuvant treatment were alive at the time of this analysis. Median survival was not reached for patients treated with consolidation durvalumab for NSCLC. Twenty-five patients died within 3 months [none after (neo)adjuvant or consolidation ICI]. Among these 25 patients, none had performance status (PS) 0 and only 7 had PS 1. Among 13 patients aged ≥80 years, 5 (38%) died within 3 months. Four of five patients treated on an individual basis outside of generally accepted indications died within 3 months. Conclusion: The overall survival outcomes observed after limited follow-up appear satisfactory. Death within 3 months was typically caused by cancer progression and mostly related to reduced PS (≥2) and/or advanced age (≥80 years).

Patterns of Care and Survival in Cancer Patients with Brain Metastases Receiving Immune Checkpoint Inhibitors

“…In our hospital's ICI-treated cancer patient population, a previous retrospective study focusing on those with short survival (maximum 3 months from start) has shown that presence of brain metastases was not among the factors explaining such unfavorable outcome, in contrast to reduced performance status (PS) or advanced age [15]. Given that patients with brain metastases represent a particular, potentially vulnerable subgroup (especially if suffering from reduced neurological or cognitive function), a detailed analysis of patterns of care and survival in an expanded database appeared warranted.…”

Discontinuation of Immune Checkpoint Inhibitor due to irAEs in NSCLC Patients With EGFR Mutation

“…Immune checkpoint inhibitors (ICIs) have transformed treatment for many advanced carcinomas including non-small cell lung cancer (NSCLC) (1)(2)(3)(4). The long-tailed plateau of survival curves in patients receiving ICI therapy is extremely positive, with a considerable cure rate in patients with advanced NSCLC (1)(2)(3)(4).…”

“…Immune checkpoint inhibitors (ICIs) have transformed treatment for many advanced carcinomas including non-small cell lung cancer (NSCLC) (1)(2)(3)(4). The long-tailed plateau of survival curves in patients receiving ICI therapy is extremely positive, with a considerable cure rate in patients with advanced NSCLC (1)(2)(3)(4). With conventional cytotoxic antitumour drugs, dosing and treatment intervals are determined by pharmacokinetics and pharmacodynamics, such as drug half-life and blood concentrations (5).…”