Second-line immunosuppressant administration for steroid-refractory immune-related adverse events in patients with lung cancer.

Autor: Ogusu S; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Harutani Y; Internal Medicine III, Wakayama Medical University, Wakayama, Japan., Tozuka T; Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan., Saito R; Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan., Koyama J; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Sakamoto H; Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan., Sonoda T; Division of Respiratory Medicine, University of Fukui Hospital, Yoshida-Gun, Fukui, Japan., Tsuchiya-Kawano Y; Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan., Oba T; Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan., Kudo K; Department of Medical Oncology, NHO Osaka Minami Medical Center, Kawachinagano-shi, Osaka, Japan., Gyotoku H; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan., Nakatomi K; Department of Respiratory Medicine, National Hospital Organization Ureshino Medical Center, Ureshino-shi, Saga, Japan., Ariyasu R; Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan. ryo.ariyasu@jfcr.or.jp.
Jazyk: angličtina
Zdroj: Cancer immunology, immunotherapy : CII [Cancer Immunol Immunother] 2023 Nov; Vol. 72 (11), pp. 3765-3772. Date of Electronic Publication: 2023 Aug 28.
DOI: 10.1007/s00262-023-03528-x
Abstrakt: Background: Evidence for use of second-line immunosuppressants for immune-related adverse events (irAEs) is inadequate. Therefore, a multicenter analysis should assess the efficacy of second-line immunosuppressants for severe irAEs associated with different malignant diseases.
Methods: This descriptive study aims to investigate the effects of second-line immunosuppressants on corticosteroid-refractory irAEs in patients with lung cancer. We analyzed the effects of second-line immunosuppressants on underlying lung cancer and associated adverse effects.
Results: Our study included 4589 patients who had received immune checkpoint inhibitor treatment, with 73 patients (1.6%) developing irAEs requiring second-line immunosuppressants. The most commonly observed irAE was pneumonitis (26 patients), followed by hepatobiliary disorders (15 patients) and enteritis (14 patients). We found a confirmed response rate of 42.3% for pneumonitis, which was lower than the response rates of 86.7% for hepatobiliary disorders and 92.9% for enteritis. The time from the start of corticosteroid therapy to the addition of a second-line immunosuppressant correlated significantly with the resolution of irAE to Grade 1 (correlation coefficients of r = 0.701, p < 0.005). The median progression-free survival and duration of response of underlying lung cancer from second-line immunosuppressant administration were 2.1 and 3.0 months, respectively. Of the patients with irAE, 27.4% developed infections and 5.5% might die due to infection.
Conclusion: Second-line immunosuppressant response was confirmed in 72.2% of irAEs in patients with lung cancer, with lower response rates observed in irAE pneumonitis compared to other irAEs.
(© 2023. The Author(s).)
Databáze: MEDLINE
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