Systematic surveillance of immune-related adverse events in clinical practice and impact of subsequent steroid medication on survival outcomes

Matsukane, Ryosuke; Suetsugu, Kimitaka; Hata, Kojiro; Matsuda, Keisuke; Nakao, Shin-ichi; Minami, H.; Watanabe, Hiroyuki; Hirota, Tomoyoshi; Egashira, Nobuaki; Ieiri, Ichiro

doi:10.1007/s10147-023-02349-3

Cited by 7 publications

(2 citation statements)

References 41 publications

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“…However, unlike other irAEs, they tend to be irreversible, leading to a need for lifelong hormone supplementation [14,18,20]. The impact of corticosteroid therapy for irAEs on ICI efficacy is unclear; the organ system affected, the primary tumor type, as well as the timing and dose of systemic steroid therapy may be significant [21][22][23][24]. It has been suggested that the use of systemic corticosteroids is a poor prognostic factor independent of the use of ICIs; however, this has not been consistently shown in patients with LC [25,26].…”

Section: Discussionmentioning

confidence: 99%

Endocrine Immune-Related Adverse Events Are Independent Predictors of Survival in Patients with Lung Cancer

Panagiotou,

Ntouraki,

Vathiotis

et al. 2024

Cancers

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Lung cancer (LC) is a serious health problem worldwide. Survival outcomes have improved over time due to the widespread use of novel therapeutic agents, including immune checkpoint inhibitors (ICIs). Endocrine immune-related adverse events (e-irAEs) are common in LC patients treated with ICIs. We performed a retrospective study of patients with LC who received treatment with ICIs at a tertiary referral center between January 2014 and October 2023. In total, 983 LC patients were included in the study. E-irAEs presented at a median time of 4.1 months and included hypothyroidism (15.6%), hyperthyroidism (4.3%), adrenal insufficiency (0.4%), hypophysitis (0.4%), and diabetes mellitus (0.2%). These toxicities were not related to the duration of treatment or the type of ICIs. Most (97.6%) e-irAEs were mild (grade 1–2). Median overall survival (OS) was higher in LC patients who experienced e-irAEs (31.6 months) compared to those who did not (10.8 months). The difference remained statistically significant in the 3-month (HR: 0.42) and 6-month landmark analysis (HR: 0.51). The OS advantage was observed in both patients with NSCLC (HR: 0.36) and SCLC (HR: 0.27). Additional research is needed to validate the role of e-irAEs as an independent predictor of survival outcomes in patients with LC.

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Section: Discussionmentioning

confidence: 99%

Endocrine Immune-Related Adverse Events Are Independent Predictors of Survival in Patients with Lung Cancer

Panagiotou,

Ntouraki,

Vathiotis

et al. 2024

Cancers

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“…The number of patients treated with each regimen, such as anti-PD-1 combined with anti-CTLA-4 antibody therapy, was small. It is important to note that the incidence of grade ≥3 irAEs in this regimen was nearly 40% [ 26 ]. In addition, these combinations may induce uncommon irAEs such as myocarditis and cytokine release syndrome [ 27 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Real-World Prevalence and Tolerability of Immune-Related Adverse Events in Older Adults with Non-Small Cell Lung Cancer: A Multi-Institutional Retrospective Study

Matsukane,

Oyama,

Tatsuta

et al. 2024

Cancers

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With cancer diagnosis occurring at older ages, the use of immune checkpoint inhibitors (ICIs) has extended to older adults. However, the safety of immune-related adverse events (irAEs) in this population remains unclear and relies on data extrapolated from younger adults. This multicenter retrospective study aimed to examine irAE prevalence and tolerability in older adults. We included 436 patients with non-small lung cancer undergoing ICI therapy and dichotomized them into two age groups (< or ≥75 years). Incidence of any irAE grade, grade ≥3 irAEs, and steroid usage after irAE occurrence was similar between younger (n = 332) and older groups (n = 104). While the younger patients with irAEs showed prolonged overall survival in the 12-month landmark Kaplan–Meier analysis (Hazard ratio (HR) 0.59, 95% confidence interval (CI) 0.38–0.89, p = 0.013), the older cohort did not (HR 0.80, 95% CI 0.36–1.78, p = 0.588). Although no differences were observed with ICI continuation or re-challenge after irAE onset, the elderly cohort had double the irAE cases that required a transition to best supportive care (BSC) (11.3% vs. 22.4%, p = 0.026). In conclusion, although irAE prevalence remains consistent regardless of age, the increased conversion to BSC post-irAE onset in older adults suggests diminished tolerability and the potential absence of favorable prognosis associated with irAEs in this population.

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Survival Impact of Glucocorticoid Administration for Adverse Events During Immune Checkpoint Inhibitor Combination Therapy in Patients with Previously Untreated Advanced Renal Cell Carcinoma

Yoshino,

Ishihara,

Nemoto

et al. 2024

Targ Oncol

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Systematic surveillance of immune-related adverse events in clinical practice and impact of subsequent steroid medication on survival outcomes

Cited by 7 publications

References 41 publications

Endocrine Immune-Related Adverse Events Are Independent Predictors of Survival in Patients with Lung Cancer

Endocrine Immune-Related Adverse Events Are Independent Predictors of Survival in Patients with Lung Cancer

Real-World Prevalence and Tolerability of Immune-Related Adverse Events in Older Adults with Non-Small Cell Lung Cancer: A Multi-Institutional Retrospective Study

Survival Impact of Glucocorticoid Administration for Adverse Events During Immune Checkpoint Inhibitor Combination Therapy in Patients with Previously Untreated Advanced Renal Cell Carcinoma

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