Real-world safety and efficacy data of immunotherapy in patients with cancer and autoimmune disease: the experience of the Hellenic Cooperative Oncology Group
| Autor: | Giannis Mountzios, Athanasios Laloysis, Sofia Lampaki, Dimitrios Daoussis, Henry Vo, George Papaxoinis, I. Binas, A. Kotsakis, Anastasios Boutis, Amanda Psyrri, Vassilis Georgoulias, Georgia Angeliki Koliou, Helena Linardou, Anastasios Vagionas, Sofia Levva, Eleni Res, Iliada Bompolaki, Elena Fountzilas, Dimitrios Bafaloukos, Helen Gogas, Emmanouil Saloustros, Athina Christopoulou, Adamantia Nikolaidi, George Fountzilas, Elias Kotteas, Anna Andreadou, Anna Koumarianou, Miltiadis Chrysanthidis, Konstantinos N. Syrigos, Marinos Tsiatas, Dionisios Spyratos, Nikolaos Kentepozidis |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Efficacy medicine.medical_treatment Immunology Thyroiditis Autoimmune Diseases 03 medical and health sciences 0302 clinical medicine Non-small cell lung cancer Immune-related adverse events Neoplasms Internal medicine Autoimmune disease medicine Clinical endpoint Corticosteroid Humans Immunology and Allergy Adverse effect Immune Checkpoint Inhibitors Aged Retrospective Studies Aged 80 and over business.industry Medical record Cancer Immunotherapy Middle Aged Prognosis medicine.disease Discontinuation Survival Rate 030104 developmental biology 030220 oncology & carcinogenesis Original Article Female Immunomodulatory drugs business Follow-Up Studies |
| Zdroj: | Cancer Immunology, Immunotherapy |
| ISSN: | 1432-0851 0340-7004 |
| DOI: | 10.1007/s00262-021-02985-6 |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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