Pre‐treatment comorbidities, C‐reactive protein and eosinophil count, and immune‐related adverse events as predictors of survival with checkpoint inhibition for multiple tumour entities

Autor: Tarun Mehra, Kanchan Dongre, Maria Boesing, Patricia Frei, Claudia Suenderhauf, Alfred Zippelius, Joerg D. Leuppi, Andreas Wicki, Anne B. Leuppi‐Taegtmeyer
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cancer Medicine, Vol 12, Iss 11, Pp 12253-12262 (2023)
Druh dokumentu: article
ISSN: 2045-7634
DOI: 10.1002/cam4.5919
Popis: Abstract Background The development of immune‐related adverse events (irAEs) may be associated with clinical efficacy of checkpoint inhibitors (CPIs) in patients with cancer. We therefore investigated the effect of irAEs and pre‐treatment parameters on outcome in a large, real‐life patient cohort. Methods We performed a single‐centre, retrospective, observational study including patients who received CPIs from 2011 to 2018 and followed until 2021. The primary outcome was overall survival, and the secondary outcome was the development of irAEs. Results In total, 229 patients with different tumour entities (41% non‐small cell lung cancer [NSCLC], 29% melanoma) received a total of 282 CPI treatment courses (ipilimumab, nivolumab, pembrolizumab or atezolizumab). Thirty‐four percent of patients developed irAEs (of these 17% had CTCAE Grade ≥3). Factors independently associated with mortality were pre‐treatment CRP ≥10 mg/L (hazard ratio [HR] 2.064, p = 0.0003), comorbidity measured by Charlson comorbidity index (HR 1.149, p = 0.014) and irAEs (HR 0.644, p = 0.036) (age‐adjusted, n = 216). Baseline eosinophil count ≤0.2 × 109/L was a further independent predictor of mortality (age‐, CRP‐, CCI‐ and irAE‐adjusted HR = 2.252, p = 0.002, n = 166). Anti‐CTLA‐4 use (p
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