Association between immune-related adverse events and efficacy of immune checkpoint inhibitors in patients with advanced hepatocellular carcinoma
| Autor: | Lawrence Wen Jun Wong, Joycelyn Lee, K. Ng, David Wai-Meng Tai, S.H. Tan, Andrea Jing Shi Ang, S.P. Choo |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Univariate analysis business.industry Proportional hazards model Immune checkpoint inhibitors Hazard ratio Common Terminology Criteria for Adverse Events Hematology medicine.disease 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Internal medicine Hepatocellular carcinoma medicine In patient business Adverse effect |
| Zdroj: | Annals of Oncology. 30:ix110 |
| ISSN: | 0923-7534 |
| Popis: | Background More patients are receiving immune checkpoint inhibitors (ICI) for advanced hepatocellular carcinoma (HCC). We aim to explore whether an association exists between the presence of irAE and the efficacy of ICI in advanced HCC. Methods We conducted a retrospective review of patients with advanced HCC who received ICIs between May 2015 - Nov 2018 at our centre. IrAE were graded according to the Common Terminology Criteria for Adverse Events v4.0. Response to ICI was evaluated based on RECIST v1.1 criteria. Results Of the 114 patients studied, median age was 67.3yrs (23.5-84.9) and 78 (89.7%) were male. 68.4% experienced irAE of any grade (n = 78), with 21.8% being grade 3-4 (n = 17). None were grade 5. Patients in the any-irAE group had comparable ORR and significantly higher DCR than the no-irAE group (23.4 vs 10.0%, p = 0.118 and 64.9 vs 30.0%, p = 0.001). Median PFS and OS in the any-irAE group were significantly longer than the no-irAE group (4.0 vs 1.4mths, p Table . 325P Cox regression analysis of the association between irAE and survival outcomes Univariate hazard ratio (95% CI) p-value Multivariate hazard ratio * (95% CI) p-value PFS Any 0.37 (0.23-0.59) 0.52 (0.31-0.90) 0.018 Hepatobiliary irAE 0.75 (0.44-1.26) 0.28 Skin irAE 0.29 (0.18-0.46) 0.32 (0.20-0.52) Gastrointestinal irAE 0.76 (0.45-1.27) 0.29 Endocrine irAE 0.27 (0.08-0.91) 0.035 0.34 (0.10-1.18) 0.091 Lung irAE 0.24 (0.06-0.97) 0.046 0.29 (0.07-1.20) 0.087 OS Any 0.27 (0.16-0.47) 0.38 (0.20-0.71) 0.003 Hepatobiliary irAE 0.56 (0.28-1.12) 0.10 Skin irAE 0.28 (0.16-0.49) 0.35 (0.19-0.64) 0.001 Gastrointestinal irAE 0.58 (0.29-1.15) 0.12 Endocrine irAE 0.36 (0.11-1.24) 0.11 Lung irAE 0.38 (0.09-1.61) 0.19 * Significant covariables in univariate analysis were included; for PFS: age category, bilirubin category; for OS: age category, albumin category, bilirubin category. Conclusions The presence of irAE in advanced HCC patients treated with ICI could possibly predict better response and survival outcomes. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure S.P. Choo: Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (self): Bristol-Myers Squibb; Advisory / Consultancy, Research grant / Funding (self): Sirtex Medical; Advisory / Consultancy, Speaker Bureau / Expert testimony: Lily; Advisory / Consultancy: Novartis; Advisory / Consultancy: Eisai; Advisory / Consultancy: Bayer; Advisory / Consultancy: Celgene; Advisory / Consultancy: Ipsen. D. Tai: Research grant / Funding (self): Bristol-Myers Squibb; Advisory / Consultancy: Merck Sharp & Dohme; Advisory / Consultancy: Eisai; Honoraria (self), Advisory / Consultancy: Bayer; Advisory / Consultancy: Ipsen; Research grant / Funding (self): Sirtex. J. Lee: Advisory / Consultancy: Ipsen; Research grant / Funding (self): Bayer. All other authors have declared no conflicts of interest. |
| Databáze: | OpenAIRE |
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