Yasuto Yoneshima1, Kentaro Tanaka1, Yoshimasa Shiraishi1, Kojiro Hata2, Hiroyuki Watanabe2, Taishi Harada3, Kohei Otsubo1, Eiji Iwama1, Hiroyuki Inoue4, Satohiro Masuda2, Yoichi Nakanishi4, Isamu Okamoto5. 1. Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 2. Department of Pharmacy, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 3. Department of Respiratory Medicine, Japan Community Healthcare Organization Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, 806-8501, Japan. 4. Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan; Center for Clinical and Translational Research, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 5. Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. Electronic address: okamotoi@kokyu.med.kyushu-u.ac.jp.
Abstract
OBJECTIVES: To examine the possible effects of antinuclear antibodies (ANA) on the safety and efficacy of programmed cell death-1 (PD-1) inhibitors in patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Clinical data including ANA status were reviewed retrospectively for patients with advanced NSCLC who received monotherapy with a PD-1 inhibitor. RESULTS: Of the 83 patients analyzed, 18 (21.7%) were positive for ANA. The incidence of immune-related adverse events (irAEs) did not differ significantly between patients with ANA (6/18, 33.3%) and those negative for ANA (21/65, 32.3%), although it tended to increase as the ANA titer increased. Progression-free survival (2.9 versus 3.8 months, p = 0.03) and overall survival (11.6 versus 15.8 months, p = 0.03) were significantly shorter in patients positive for ANA than in those without ANA. CONCLUSION: PD-1 inhibitors can be administered safely in advanced NSCLC patients positive for ANA without obvious exacerbation of autoimmune disease, although patients with a high titer of such antibodies may warrant close monitoring. However, the presence of ANA might be associated with a poor outcome of such treatment.
OBJECTIVES: To examine the possible effects of antinuclear antibodies (ANA) on the safety and efficacy of programmed cell death-1 (PD-1) inhibitors in patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Clinical data including ANA status were reviewed retrospectively for patients with advanced NSCLC who received monotherapy with a PD-1 inhibitor. RESULTS: Of the 83 patients analyzed, 18 (21.7%) were positive for ANA. The incidence of immune-related adverse events (irAEs) did not differ significantly between patients with ANA (6/18, 33.3%) and those negative for ANA (21/65, 32.3%), although it tended to increase as the ANA titer increased. Progression-free survival (2.9 versus 3.8 months, p = 0.03) and overall survival (11.6 versus 15.8 months, p = 0.03) were significantly shorter in patients positive for ANA than in those without ANA. CONCLUSION: PD-1 inhibitors can be administered safely in advanced NSCLCpatients positive for ANA without obvious exacerbation of autoimmune disease, although patients with a high titer of such antibodies may warrant close monitoring. However, the presence of ANA might be associated with a poor outcome of such treatment.
Authors: T Sakakida; T Ishikawa; Y Chihara; S Harita; J Uchino; Y Tabuchi; S Komori; J Asai; T Narukawa; A Arai; H Tsunezuka; T Kosuga; H Konishi; M Moriguchi; H Yasuda; F Hongo; M Inoue; S Hirano; O Ukimura; Y Itoh; T Taguchi; K Takayama Journal: Clin Transl Oncol Date: 2019-10-01 Impact factor: 3.405
Authors: Mitchell S von Itzstein; Amrit S Gonugunta; Helen G Mayo; John D Minna; David E Gerber Journal: Cancer J Date: 2020 Nov/Dec Impact factor: 2.074