Background and Importance According to some data, there is evidence suggesting correlation between immune-related adverse events (irAEs) and favorable clinical outcomes in several tumour types during the treatment with immune check-point inhibitors.
Aim and Objectives To asses the presence of irAEs and if it is associated with clinical benefit in patients diagnosed with non-small-cell lung cancer who are treated with immune check-point inhibitors.
Material and Methods Observational and retrospective study including patients with NSCLC treated with pembrolizumab, atezolizumab or nivolumab in first or second-line therapy (March 2018- August 2022). To assess treatment effectiveness, the overall survival (OS) and progression-free survival (PFS) were evaluated with Kaplan-Meier method. The survival curves were compared based on the presence of irAEs or not. The severity of irAES were graded based on National Cancer Institute´s Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Results 133 patients were evaluated: 74% men, mean age of 66.84 ± 9.06, 58% adenocarcinoma, PD-L1 >50% 46% and 82.7% ECOG 1.
54.8% received pembrolizumab, 30.8% atezolizumab and 14.3% nivolumab.
The mean duration of treatment was 8.4 ± 10.4 months.
194 irAEs were recorded. 61.6% of the patients experienced almost one irAEs of any grade. Incidence of toxicity was more likely with pembrolizumab (59,8%). Severity of the irAEs were mild (grade 1) in most cases (78.3%), followed by moderate (grade 2) 15.4%, severe (grade 3) 5.6% and life-threatening (grade 4) 0.5%.
The most common irAE were gastrointestinal (36%), followed by cutaneous(22%), musculoskeletal (11%), haematological (9.3%) and endocrine (6.7%).
In 5.3% of patients the treatment had to be permanently retired due to toxicity, while 14,3% the treatment was temporarily discontinued until the irAE resolution. However, 2.2% needed a hospital admission until irAEs was released.
The median PFS was 8.2 months in patients who have an irAE and 2.2 months in those without it (p<0.05). The median OS was 10.9 months in patients who have an irAE and 3 months in those without i(p<0.05).
Conclusion and Relevance In our cohort of patients, more than a half underwent at least one irAE, being pembrolizumab the drug that has produced most irAEs. The presence of irAE was significantly associated with improved PFS and OS.
Conflict of Interest No conflict of interest
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