Real-world safety and efficacy data of immunotherapy in patients with cancer and autoimmune disease: the experience of the Hellenic Cooperative Oncology Group.

Autor: Fountzilas, Elena, Lampaki, Sofia, Koliou, Georgia-Angeliki, Koumarianou, Anna, Levva, Sofia, Vagionas, Anastasios, Christopoulou, Athina, Laloysis, Athanasios, Psyrri, Amanda, Binas, Ioannis, Mountzios, Giannis, Kentepozidis, Nikolaos, Kotsakis, Athanassios, Saloustros, Emmanouil, Boutis, Anastasios, Nikolaidi, Adamantia, Fountzilas, George, Georgoulias, Vassilis, Chrysanthidis, Miltiadis, Kotteas, Elias
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Zdroj: Cancer Immunology, Immunotherapy; Feb2022, Vol. 71 Issue 2, p327-337, 11p
Abstrakt: Background: Data on the safety and efficacy of immune checkpoint inhibitors (ICI) in patients with concurrent autoimmune diseases (AID) are limited. Methods: We performed a retrospective multicenter review of medical records of patients with cancer and underlying AID who received ICI. The primary endpoint was progression-free survival (PFS). Results: Among 123 patients with pre-existing AID who received ICI, the majority had been diagnosed with non-small cell lung cancer (NSCLC, 68.3%) and melanoma (14.6%). Most patients had a rheumatologic (43.9%), or an endocrine disorder (21.1%). Overall, 74 (60.2%) patients experienced an immune-related adverse event (irAE) after ICI initiation, AID flare (25.2%), or new irAE (35%). Frequent irAEs included thyroiditis, dermatitis and colitis. ICI was permanently discontinued due to unacceptable (8.1%) or fatal (0.8%) toxicity. In patients with NSCLC, corticosteroid treatment at the initiation of immunotherapy was associated with poor PFS (HR = 2.78, 95% CI 1.40–5.50, p = 0.003). The occurrence of irAE was associated with increased PFS (HR = 0.48, 95% CI 0.25–0.92, p = 0.026). Both parameters maintained their independent prognostic significance. Conclusions: ICI in patients with cancer and pre-existing AID is associated with manageable toxicity that infrequently requires treatment discontinuation. However, since severe AID flare might occur, expected ICI efficacy and toxicity must be balanced. Clinical trial identifier: NCT04805099 [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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