TY - JOUR
T1 - Impact of Intercurrent Introduction of Steroids on Clinical Outcomes in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients under Immune-Checkpoint Inhibitors (ICI).
AU - De Giglio, Andrea
AU - Mezquita, Laura
AU - Auclin, Edouard
AU - Blanc-Durand, Félix
AU - Riudavets, Mariona
AU - Caramella, Caroline
AU - Martinez, Gala
AU - Benitez, Jose Carlos
AU - Martín-Romano, Patricia
AU - El-Amarti, Lamiae
AU - Hendriks, Lizza
AU - Ferrara, Roberto
AU - Naltet, Charles
AU - Lavaud, Pernelle
AU - Gazzah, Anas
AU - Adam, Julien
AU - Planchard, David
AU - Chaput, Nathalie
AU - Besse, Benjamin
PY - 2020/9/1
Y1 - 2020/9/1
N2 - BACKGROUND: Baseline steroids before ICI have been associated with poor outcomes, particularly when introduced due to cancer symptoms. METHODS: Retrospective analysis of advanced NSCLC patients treated with ICI. We collected the use of intercurrent steroids (≥10 mg of prednisone-equivalent) within the first eight weeks of ICI. We correlated steroid use with patient outcomes according to the indications. RESULTS: 413 patients received ICI, 299 were steroids-naïve at baseline. A total of 49 patients received intercurrent steroids (16, of whom 38 for cancer-related symptoms and 11 for other indications, such as immune-related events. Overall, median (m) progression-free survival (PFS) was 1.9 months (mo.) [95 1.8-2.4] and overall survival (OS) 10 mo. [95 8.1-12.9]. Intercurrent steroids under ICI correlated with a shorter PFS/OS (1.3 and 2.3 mo. respectively, both p textless 0.0001). Intercurrent steroids for cancer-related symptoms correlated with poorest mPFS [1.1 mo.; 95 0.9-1.5] and mOS [1.9 mo.; 95 1.5-2.4; p textless 0.0001)]. No mOS and mPFS differences were found between cancer-unrelated-steroid group and no-steroid group. Steroid use for cancer-related symptoms was an independent prognostic factor for poor PFS [HR 2.64; 95 1.2-5.6] and OS [HR 4.53; 95 1.8-11.1], both p textless 0.0001. CONCLUSION: Intercurrent steroids during ICI had no detrimental prognostic impact if the indication was unrelated to cancer symptoms.
AB - BACKGROUND: Baseline steroids before ICI have been associated with poor outcomes, particularly when introduced due to cancer symptoms. METHODS: Retrospective analysis of advanced NSCLC patients treated with ICI. We collected the use of intercurrent steroids (≥10 mg of prednisone-equivalent) within the first eight weeks of ICI. We correlated steroid use with patient outcomes according to the indications. RESULTS: 413 patients received ICI, 299 were steroids-naïve at baseline. A total of 49 patients received intercurrent steroids (16, of whom 38 for cancer-related symptoms and 11 for other indications, such as immune-related events. Overall, median (m) progression-free survival (PFS) was 1.9 months (mo.) [95 1.8-2.4] and overall survival (OS) 10 mo. [95 8.1-12.9]. Intercurrent steroids under ICI correlated with a shorter PFS/OS (1.3 and 2.3 mo. respectively, both p textless 0.0001). Intercurrent steroids for cancer-related symptoms correlated with poorest mPFS [1.1 mo.; 95 0.9-1.5] and mOS [1.9 mo.; 95 1.5-2.4; p textless 0.0001)]. No mOS and mPFS differences were found between cancer-unrelated-steroid group and no-steroid group. Steroid use for cancer-related symptoms was an independent prognostic factor for poor PFS [HR 2.64; 95 1.2-5.6] and OS [HR 4.53; 95 1.8-11.1], both p textless 0.0001. CONCLUSION: Intercurrent steroids during ICI had no detrimental prognostic impact if the indication was unrelated to cancer symptoms.
KW - immunotherapy
KW - non-small cell lung cancer
KW - steroids
U2 - 10.3390/cancers12102827
DO - 10.3390/cancers12102827
M3 - Article
VL - 12
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 10
ER -