PURPOSE: Baseline use of corticosteroids is associated with poor outcomes in patients with non-small-cell lung cancer (NSCLC) treated with programmed cell death-1 axis inhibition. To approach the question of causation versus correlation for this association, we examined outcomes in patients treated with immunotherapy depending on whether corticosteroids were administered for cancer-related palliative reasons or cancer-unrelated indications. PATIENTS AND METHODS: Clinical outcomes in patients with NSCLC treated with immunotherapy who received ≥ 10 mg prednisone were compared with outcomes in patients who received 0 to < 10 mg of prednisone. RESULTS: Of 650 patients, the 93 patients (14.3%) who received ≥ 10 mg of prednisone at the time of immunotherapy initiation had shorter median progression-free survival (mPFS) and median overall survival (mOS) times than patients who received 0 to < 10 mg of prednisone (mPFS, 2.0 v 3.4 months, respectively; P = .01; mOS, 4.9 v 11.2 months, respectively; P < .001). When analyzed by reason for corticosteroid administration, mPFS and mOS were significantly shorter only among patients who received ≥ 10 mg prednisone for palliative indications compared with patients who received ≥ 10 mg prednisone for cancer-unrelated reasons and with patients receiving 0 to < 10 mg of prednisone (mPFS, 1.4 v 4.6 v 3.4 months, respectively; log-rank P < .001 across the three groups; mOS, 2.2 v 10.7 v 11.2 months, respectively; log-rank P < .001 across the three groups). There was no significant difference in mPFS or mOS in patients receiving ≥ 10 mg of prednisone for cancer-unrelated indications compared with patients receiving 0 to < 10 mg of prednisone. CONCLUSION: Although patients with NSCLC treated with ≥ 10 mg of prednisone at the time of immunotherapy initiation have worse outcomes than patients who received 0 to < 10 mg of prednisone, this difference seems to be driven by a poor-prognosis subgroup of patients who receive corticosteroids for palliative indications.
PURPOSE: Baseline use of corticosteroids is associated with poor outcomes in patients with non-small-cell lung cancer (NSCLC) treated with programmed cell death-1 axis inhibition. To approach the question of causation versus correlation for this association, we examined outcomes in patients treated with immunotherapy depending on whether corticosteroids were administered for cancer-related palliative reasons or cancer-unrelated indications. PATIENTS AND METHODS: Clinical outcomes in patients with NSCLC treated with immunotherapy who received ≥ 10 mg prednisone were compared with outcomes in patients who received 0 to < 10 mg of prednisone. RESULTS: Of 650 patients, the 93 patients (14.3%) who received ≥ 10 mg of prednisone at the time of immunotherapy initiation had shorter median progression-free survival (mPFS) and median overall survival (mOS) times than patients who received 0 to < 10 mg of prednisone (mPFS, 2.0 v 3.4 months, respectively; P = .01; mOS, 4.9 v 11.2 months, respectively; P < .001). When analyzed by reason for corticosteroid administration, mPFS and mOS were significantly shorter only among patients who received ≥ 10 mg prednisone for palliative indications compared with patients who received ≥ 10 mg prednisone for cancer-unrelated reasons and with patients receiving 0 to < 10 mg of prednisone (mPFS, 1.4 v 4.6 v 3.4 months, respectively; log-rank P < .001 across the three groups; mOS, 2.2 v 10.7 v 11.2 months, respectively; log-rank P < .001 across the three groups). There was no significant difference in mPFS or mOS in patients receiving ≥ 10 mg of prednisone for cancer-unrelated indications compared with patients receiving 0 to < 10 mg of prednisone. CONCLUSION: Although patients with NSCLC treated with ≥ 10 mg of prednisone at the time of immunotherapy initiation have worse outcomes than patients who received 0 to < 10 mg of prednisone, this difference seems to be driven by a poor-prognosis subgroup of patients who receive corticosteroids for palliative indications.
Authors: Leisha A Emens; Sylvia Adams; Ashley Cimino-Mathews; Mary L Disis; Margaret E Gatti-Mays; Alice Y Ho; Kevin Kalinsky; Heather L McArthur; Elizabeth A Mittendorf; Rita Nanda; David B Page; Hope S Rugo; Krista M Rubin; Hatem Soliman; Patricia A Spears; Sara M Tolaney; Jennifer K Litton Journal: J Immunother Cancer Date: 2021-08 Impact factor: 13.751
Authors: Charissa A C Jessurun; Alexander F C Hulsbergen; Anouk E de Wit; Ishaan A Tewarie; Tom J Snijders; Joost J C Verhoeff; John G Phillips; David A Reardon; Rania A Mekary; Marike L D Broekman Journal: Neuro Oncol Date: 2021-08-02 Impact factor: 12.300
Authors: Mark N Sorial; Justin P Huynh; Christopher G Azzoli; Justin C Liauw; Robert D Brunault; Christine M Collins; Andrew R Zullo Journal: Eur J Cancer Date: 2021-01-08 Impact factor: 9.162
Authors: Ahmad A Tarhini; Ni Kang; Sandra J Lee; F Stephen Hodi; Gary I Cohen; Omid Hamid; Laura F Hutchins; Jeffrey A Sosman; Harriet M Kluger; Zeynep Eroglu; Henry B Koon; Donald P Lawrence; Kari L Kendra; David R Minor; Carrie B Lee; Mark R Albertini; Lawrence E Flaherty; Teresa M Petrella; Howard Streicher; Vernon K Sondak; John M Kirkwood Journal: J Immunother Cancer Date: 2021-05 Impact factor: 13.751