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DOI: 10.1055/s-0041-1740243
Association of Immune-Related Adverse Effects and Survival in Solid Tumor Patients Treated with PD1 Inhibitors
Source of Funding The authors or institution did not receive any funding for this research.Abstract
Background The development of immune-related adverse effects (irAEs) can corroborate with the response to immune checkpoint inhibitors (ICIs), including programmed cell death 1 (PD1) inhibitors. However, there is extremely limited data on the association of irAEs with survival in patients who have shown a response to ICIs.
Patients and Methods This study is a retrospective audit of the prospectively collected database of patients who received PD1 inhibitors for advanced solid tumors. Responders were defined as patients who attained the best response of either complete response or partial response. Time-to-event analysis was done using the Kaplan–Meier estimator, and the hazard ratio (HR) was calculated by using Cox proportional model. A point-biserial correlation was used to find out the potential influence of irAEs on overall survival (OS).
Results A total of 155 patients (49% lung cancer, 31% head and neck cancer) who received ICI during the specified period were evaluated for this study. The overall response rate was 19.4% and disease control rate was 43.2%. The median (OS) for patients who developed irAE was 12.3 months (95% confidence interval [CI]: 8.9–15.6), while it was not reached for patients without irAE (HR: 10.5, 95% CI: 1.2–NR, p = 0.007). One-year OS for the corresponding group of patients was 53.6% (standard deviation [SD]: 15.6) versus 92.9% (SD: 6.9), respectively. Among responders, 12 (40%) developed at least grade 1 irAE, while among nonresponders, 38 (30.4%) developed irAE (p = 0.312).
Conclusions In our study, we found significant improvement in survival of solid tumor patients treated with ICIs who developed irAEs on treatment as compared with those who did not. On specifically analyzing patients who responded to ICIs, there was no difference in OS who developed irAEs versus those who did not. However, this needs to be studied in a larger sample to reach a definite conclusion.
Keywords
immune checkpoint inhibitors - responders - survival outcomes - immune-related adverse effects - solid tumorsAuthors' Contributions
Vanita Noronha and Kumar Prabhash conceptualized and designed the manuscript.
Vanita Noronha, Amit Joshi, Vijay Maruti Patil, Amit Joshi, Nandini Menon, and Kumar Prabhash were involved in provision of patients.
Akhil Kapoor, Amit Kumar, Abhishek Mahajan, Amit Janu, and Rajiv Kumar were involved in collection and assembly of data.
Akhil Kapoor, Vanita Noronha, and Kumar Prabhash were involved in data analysis and interpretation.
All authors have contributed in writing of the manuscript. All the authors gave final approval for the manuscript and were accountable for all aspects of the work.
Publication History
Article published online:
19 September 2022
© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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