Predictors of immune-related adverse events and outcomes in patients with NSCLC treated with immune-checkpoint inhibitors

Data de publicação: 01/01/2024 Data Ahead of Print: 01/06/2024

Autores da FMUP

Hélder Novais E Bastos

Autor

Participantes de fora da FMUP

Serino M.
Freitas C.
Martins M.
Ferreira P.
Cardoso C.
Veiga F.
Santos V.
Araújo D.
Magalhães A.
Queiroga H.
Fernandes G.
Hespanhol V.

Unidades de investigação

Medicina
RISE-Health

Investigador

Fernando Carlos De Landér Schmitt

Abstract

Objective: To identify predictors of immune-related adverse events (IRAEs) in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). Assess associations between outcomes and the development of IRAEs. Methods: Retrospective analysis of patients with NSCLC treated with ICIs between 2016 and 2020 in the Pulmonology Department of our hospital. Patients with and without IRAEs were compared. A logistic regression analysis was performed to determine predictors of IRAEs. Progression-free survival (PFS) and overall survival (OS) curves were calculated using the Kaplan-Meier method, and the long-rank test was used to assess survival differences between groups. Univariate and multivariate Cox proportional-hazards regression models were used to identify factors associated with PFS and OS. The value considered statistically significant was p=0.05. Results: A total of 184 patients (77.7% men, mean age 66.9±9.5 years) treated with ICIs were analyzed. During follow-up, 49 (26.6%) patients developed IRAEs and 149 (81.0%) died. According to the multivariate logistic regression analysis, treatment with statins (OR:3.15; p = 0.007), previous systemic corticosteroid therapy (OR:3.99; p = 0.001), disease controlled as response to ICI (OR:5.93; p < 0.001) and higher hemoglobin values (OR:1.28; p = 0.040) were independent predictors for the development of IRAEs. Patients who developed IRAEs had significantly longer medians of PFS (41.0 vs 9.0 weeks, p < 0.001) and OS (89.0 vs 28.0 weeks; p < 0.001). Conclusions: Patients treated with statins, pre-ICI systemic corticosteroids, higher baseline hemoglobin value and controlled disease as initial response to ICI had a higher risk of developing IRAEs. The development of IRAEs was associated with better outcomes. © 2022 Sociedade Portuguesa de Pneumologia

Dados da publicação

ISSN/ISSNe:: 2531-0429, 2531-0437
Tipo:: Article
Páginas:: 352-361
DOI:: 10.1016/j.pulmoe.2022.03.003
Link para outro recurso:: www.scopus.com

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Filiações

Serino M.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Freitas C.:: Faculty of Medicine, University of Porto, Porto, Portugal

Pulmonology Department, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
Martins M.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Ferreira P.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Cardoso C.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Veiga F.:: Faculty of Medicine, University of Porto, Porto, Portugal
Santos V.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Araújo D.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Novais-Bastos H.:: Faculty of Medicine, University of Porto, Porto, Portugal

Pulmonology Department, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
Magalhães A.:: Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal
Queiroga H.:: Faculty of Medicine, University of Porto, Porto, Portugal

Pulmonology Department, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
Fernandes G.:: Faculty of Medicine, University of Porto, Porto, Portugal

Pulmonology Department, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
Hespanhol V.:: Faculty of Medicine, University of Porto, Porto, Portugal

Pulmonology Department, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal

Keywords

Aged; Carcinoma, Non-Small-Cell Lung; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immune Checkpoint Inhibitors; Kaplan-Meier Estimate; Lung Neoplasms; Male; Middle Aged; Progression-Free Survival; Proportional Hazards Models; Retrospective Studies; Risk Factors; Treatment Outcome; atezolizumab; C reactive protein; hemoglobin; immune checkpoint inhibitor; K ras protein; lactate dehydrogenase; nivolumab; pembrolizumab; programmed death 1 ligand 1; hydroxymethylglutaryl coenzyme A reductase inhibitor; immune checkpoint inhibitor; adverse event; aged; arthralgia; Article; cancer staging; cancer therapy; clinical practice; colitis; corticosteroid therapy; disease control; dyslipidemia; ECOG Performance Status; female; follow up; gene mutation; high risk population; histology; human; Kaplan Meier method; leukocyte count; logistic regression analysis; major clinical study; male; metastasis; myalgia; neutrophil lymphocyte rat