Background and Importance Symptomatic management of cancer patients often involves the use of corticosteroids. Recently, an association has been found between baseline corticosteroid levels and the response rate to immunotherapy in non-small-cell lung cancer (NSCLC).
Aim and Objectives Analyse the impact of corticosteroid administration on the effectiveness of immunotherapy.
Material and Methods Retrospective and descriptive study including patients who initiated immunotherapy between 2014 and 2021 for the treatment of locally advanced or metastatic stage NSCLC. Patients without a response assessment were excluded.
The following variables were collected and analysed through the oncology patient management programme and the electronic medical record: age, sex, Eastern Cooperative Oncology Group (ECOG), histology, drug, duration of treatment.
According to their pharmacy dispensing record, patients were classified into two groups: those who had received corticosteroids at doses higher than 10 mg of prednisone or equivalent within two months (before or after) of immunotherapy initiation the start of immunotherapy and patients who did not receive corticosteroids in that period of time.
Effectiveness was assessed by comparing Progression Free Survival (PFS) between the two groups of patients.
Results The study included 144 patients (103 men) with a mean age of 66 years. 97% of patients had an ECOG ≤ 1 at baseline. In terms of histology, 65% were adenocarcinomas, 33% were epidermoid and the remaining 2% were undifferentiated NSCLC. 47% of patients were treated with pembrolizumab, 51% with atezolizumab and the remaining, 26% with nivolumab.
The corticosteroids prescribed were prednisone (50%), dexamethasone (38%) and methylprednisolone (3%).
The group of patients who received corticosteroids had a PFS of 3,72 months (95% CI; 2,76-6), while the group of patients who did not receive corticosteroids had a PFS of 5,52 months (95% CI; 4,56-9). The differences found were statistically significant (p=0,021).
Conclusion and Relevance The use of corticosteroids at doses higher than 10 mg prednisone or equivalent within two months (before or after) of immunotherapy initiation has been shown to reduce PFS of patients with NSCLC.
Conflict of Interest No conflict of interest
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