Hammad Shafqat1, Theodore Gourdin2, Amy Sion3. 1. Division of Hematology and Oncology, Medical University of South Carolina, 39 Sabin Street, MSC 635, Charleston, SC, USA. Electronic address: shafqat@musc.edu. 2. Division of Hematology and Oncology, Medical University of South Carolina, 39 Sabin Street, MSC 635, Charleston, SC, USA. Electronic address: gourdith@musc.edu. 3. Department of Pharmacy, Medical University of South Carolina, 150 Ashley Avenue, Charleston, SC, USA. Electronic address: siona@musc.edu.
Abstract
BACKGROUND: Immune-related adverse events (irAEs) are commonly encountered, when using programmed death-1/programmed death-ligand-1 (anti-PD-1/PD-L1) therapy and are often managed with corticosteroids. The effect of irAEs, particularly when steroids are required, on patient survival is not well established. METHODS: In this retrospective analysis, data for 157 patients with various tumor types treated with anti-PD-1/PD-L1 therapy were obtained. Kaplan-Meier and Cox regression analyses were used to assess the effect of irAEs and corticosteroids on progression-free survival (PFS). RESULTS: A total of 45 irAEs were recorded for 157 patients. Twenty-one patients received systemic corticosteroids. Patients who developed irAEs, as well as those who received systemic corticosteroids, had improved PFS by Kaplan-Meier estimate. Multivariate Cox regression showed that irAEs were associated with improved PFS (hazard ratio of 0.33, P <0.001) which persisted even with use of systemic corticosteroids (hazard ratio of 0.38, P = 0.03). CONCLUSIONS: irAEs are associated with improved PFS in patients receiving anti-PD-1/PD-L1 therapy. This association does not appear to be altered by the use of systemic corticosteroids.
BACKGROUND: Immune-related adverse events (irAEs) are commonly encountered, when using programmed death-1/programmed death-ligand-1 (anti-PD-1/PD-L1) therapy and are often managed with corticosteroids. The effect of irAEs, particularly when steroids are required, on patient survival is not well established. METHODS: In this retrospective analysis, data for 157 patients with various tumor types treated with anti-PD-1/PD-L1 therapy were obtained. Kaplan-Meier and Cox regression analyses were used to assess the effect of irAEs and corticosteroids on progression-free survival (PFS). RESULTS: A total of 45 irAEs were recorded for 157 patients. Twenty-one patients received systemic corticosteroids. Patients who developed irAEs, as well as those who received systemic corticosteroids, had improved PFS by Kaplan-Meier estimate. Multivariate Cox regression showed that irAEs were associated with improved PFS (hazard ratio of 0.33, P <0.001) which persisted even with use of systemic corticosteroids (hazard ratio of 0.38, P = 0.03). CONCLUSIONS: irAEs are associated with improved PFS in patients receiving anti-PD-1/PD-L1 therapy. This association does not appear to be altered by the use of systemic corticosteroids.
Authors: Michael F Gensheimer; Balasubramanian Narasimhan; A Solomon Henry; Douglas J Wood; Daniel L Rubin Journal: JCO Clin Cancer Inform Date: 2022-06